Experience in UM/CM/QA/Managed Care Medical/Surgical experience Utilization Management (UM) or (UR) Utilization Review... on where clinical care is being provided. Preferred Certification in utilization management or a related field SKILLS Working...
. This job implements effective utilization management strategies including: review of appropriateness of health care services, application...Company : Highmark Inc. Job Description : JOB SUMMARY Weekend Remote RN - 3 days per week plus weekends...
be required depending on where clinical care is being provided. Preferred Certification in utilization management or a related field...Company : Highmark Inc. Job Description : JOB SUMMARY This job implements effective utilization management...
be required depending on where clinical care is being provided. Preferred Certification in utilization management or a related field...Company : Highmark Inc. Job Description : JOB SUMMARY This job implements effective utilization management...
and are within the care manager’s professional discipline. For assigned case load, create care plans to address members’ identified... Bachelor's Degree in Nursing EXPERIENCE Required 7 years in any combination of clinical, case/utilization management...
, state specific and NCQA compliance criteria as related to Transitions of Care. Coordination with Utilization Management... stakeholders to identify and address patient needs (e.g., care team, social work, behavioral health, utilization management, Hard...