Specialist II-Utilization Mngt - Part Time 20 hours week, every other weekend
Description***Must have BSN AND Utilization Management or Utilization Review Experience***Schedule: 20 hours weekly, every other weekend (would work between 4-6 hours every other Saturday & Sunday), remote. Must live locallySUBFUNCTION DEFINITION: Utilization Management program is to assure that all members receive all medically necessary services at the appropriate level and setting of care in a timely, efficient manner. The Medical Management Program evaluates the appropriateness of care, over and underutilization of both inpatient and outpatient services, and provides ongoing performance feedback to the Managed Care Plan derived from prospective, concurrent, and retrospective review of clinical information.Scope: Responsible
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