Director Optum Utilization Review Jobs in Raleigh, NC

... to Director when needed. Screens all cases against high risk screens for discharge planning ... One year utilization and review experience. Experience with MCG authorization criteria preferred.

... to Director when needed. Screens all cases against high risk screens for discharge planning ... One year utilization and review experience. Experience with MCG authorization criteria preferred.

Perform other duties as assigned by the Director of Utilization Review. Qualifications : Minimum Education/Certifications/OTJ Experience : * BA in Psychology or a related field. * Three to five (5) ...

Utilization and Quality Management/Outcomes experience preferred. Previous work experience with a ... Direct: 732-549-5302

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

The Utilization Management Nurse performs medical necessity and benefit review requests in ... Director (MD) for medical director oversight and necessity determinations. • Communicates ...

The Utilization Management Nurse performs medical necessity and benefit review requests in ... Director (MD) for medical director oversight and necessity determinations. • Communicates ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

ED, Direct Admit, Transfers). * Manage concurrent cases to resolution care that may impact payer ... Reviews records for medical necessity and collaborates with physician (s) and members of the care ...

The Director of Utilization Management (UM) for Physical Health is responsible for administering ... Oversee the UM Unit reviewing physical health services * Ensure consistent application of medical ...

The Director of Utilization Management (UM) for Physical Health is responsible for administering ... Oversee the UM Unit reviewing physical health services * Ensure consistent application of medical ...

... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... May assist the Senior Medical Director in research activities/questions related to the Utilization ...

... when conducting utilization review or an appeals consideration and cannot be located on a US ... Director Equivalent Workshift: 1st Shift (United States of America) Job Family: MED > Licensed ...