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Description The Manager, Pre-Authorization Nursing reviews prior authorization requests for appropriate care and ... the appropriate stakeholder. The Manager, Pre-Authorization Nursing works within specific guidelines ... and goals. Responsibilities The..
Description The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The Compliance Nurse ..
Description The Compliance Nurse 2 reviews utilization management activities ... waste, and abuse. The Compliance Nurse 2 work assignments are varied ... of action. Responsibilities The Compliance Nurse 2- Auditor..
... and the State regarding Prior Authorization reviews, prepayment retrospective reviews, and ... and daily guidance to prior authorization team members ensuring that the ... under-utilization of services. Oversee prior..
Description The RN, Compliance Nurse 2 reviews utilization management activities ... and abuse. The RN Compliance Nurse 2 work assignments are varied ... action. Responsibilities The RN Compliance Nurse 2..
... Develops programs to improve UM nurse competencies (critical thinking skills, interpreting ... years of Utilization Management (prior authorization) experience working in managed care ... you to participate in a..
