Utilization Management Case Manager - PA RN

VirtualVocations
Jackson Heights, New York, United States
Full-time

A company is looking for a Case Manager - Utilization Management.Key ResponsibilitiesReview patient admissions to evaluate appropriateness and ensure compliance with third-party payer requirementsCollaborate with care managers and other departments to facilitate patient class assignments and maximize reimbursementParticipate in performance improvement processes to enhance departmental efficiency and effectivenessRequired QualificationsSpecialized Diploma in nursing2 years of previous utilization review experience2 years of knowledge of utilization management related to third-party payersRN - Licensed Registered Nurse in the state of Pennsylvania upon hireKnowledge of evidence-based clinical decision support criteria

15 hours ago
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