Necessity criteria, the management of quality health care resources for achievement of desired outcomes, and coordination.... Monitors utilization of all services for fraud and abuse. Performs pre-authorization and pharmacy reviews and documents...
to department policies, procedures, quality standards, and safety standards. Direct management of the Utilization Management Team... to assure and maintain high quality and productivity standards; ensure results-oriented utilization management, timely customer...
Organization (MRO) Required Active DC RN license Required Experience in Case and Utilization Management..., integration, and overall operational direction of the utilization management and case management programs within MedStar Family...
required Leadership and management experience preferred Licenses and Certifications RN - Registered Nurse - State Licensure... capacity management efforts; ensures unit activities and patient throughput proceed smoothly. In collaboration with the...
General Summary of Position Serves as a member of the Case Management Team and applies RN clinical expertise..., promotes effective case management and utilization of resources, and works to achieve optimal clinical and resource outcomes...
resource role for colleagues in unit management. ADMINISTRATIVE: Acts as a consultant for nursing staff in the clinical... management of patients. ADMINISTRATIVE: Provides input to the ongoing clinical evaluation of staff. ADMINISTRATIVE: Exhibits...
years of management and leadership experience preferred Licenses and Certifications RN - Registered Nurse - State...'s (DON) leadership/management team and is responsible for one or more defined units/departments of organized nursing...