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Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..
Description The SC Medicaid CMO, RVP Health Services (CMO)relies on medical background to create and oversee clinical strategy for the region. The CMO requires an in-depth understanding of how organization capabilities ..
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... to make determinations whether requested services, requested level of care, and/or ... and appeals processes, and outpatient services and equipment, within their scope. ... medical interpretation and determinations whether..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Manager, Utilization Management Nursing utilizes clinical ... documentation and communication of medical services and/or benefit administration determinations. The ... and/or benefit administration determinations. The Manager, Utilization Management Nursing..