Description & Requirements Maximus is currently hiring for a Nurse Manager - Appeals to join our State East - Appeals... team. The Manager is responsible for overseeing a team of clinical staff who are responsible for appeals and case review...
with care management on referral of members, as appropriate Performs clinical reviews for member and provider appeals related... position to all audiences Performs other duties as assigned Position: UM Outpatient Clinical Review Nurse /Utilization...
experience as a case/care manager, utilization management nurse, home care, or hospital setting; or an equivalent combination...SUMMARY: Utilization review: The Nurse Specialist is responsible for delivering medical or behavioral health...