Utilization management jobs in Little Rock, Arkansas - Page 2Crear alertas

The Nurse for Utilization Management Appeals plays a critical role in the coordination, documentation, and communication of medical services and benefit determinations. Background in utilization management. Satellite, cellular, and microwave connections may only be used with management approval.

Utilization Management: Conducts and monitors clinical review cases to ensure medical necessity of inpatient and outpatient services, diagnostic procedures, out-of-network services, and surgery; documenting all relevant and specific information; and screens, prioritizes and organizes determination r

Previous experience in utilization management/utilization review for a health plan or acute care setting. The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations.

Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system

The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of behavioral health services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work assignments are var

The Staff Utilization Management Pharmacist (VSP/PT) is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. The Staff Utilization Management Pharmacist (VSP/PT) is a clinical professional responsible for

Two (2) or more years of home health experience and/or utilization management experience. The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization