documentation of Member interactions in ACFC electronic care management platforms where applicable. Monitor appropriate utilization.... Current and unrestricted Registered Nurse licensure. Eligible to sit for Case Management certification after 12 months...
, Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical... Management will also be counted upon to: Conduct utilization management reviews by assessing medical necessity, appropriateness...
field. Hospital utilization review/utilization management experience. Preferred Clinical appeals experience. Preferred...Scope of Work This role includes accountability for utilization review (UR) and may include admission, concurrent...
in ACFC electronic care management platforms where applicable Monitor appropriate utilization and coordinate services..., pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services...
in ACFC electronic care management platforms where applicable Monitor appropriate utilization and coordinate services..., pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services...
in ACFC electronic care management platforms where applicable Monitor appropriate utilization and coordinate services..., pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services...
interactions in ACFC electronic care management platforms where applicable Monitor appropriate utilization and coordinate services..., pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services...
documentation of Member interactions in ACFC electronic care management platforms where applicable. Monitor appropriate utilization.... Current and unrestricted Registered Nurse licensure. Eligible to sit for Case Management certification after 12 months...
documentation of Member interactions in ACFC electronic care management platforms where applicable. Monitor appropriate utilization.... Current and unrestricted Registered Nurse licensure. Eligible to sit for Case Management certification after 12 months...
documentation of Member interactions in ACFC electronic care management platforms where applicable. Monitor appropriate utilization..., pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services...