Join a growing team of professionals who truly value the contribution of their RN’s!!!
Manage the day-to-day operations of the utilization management function. Communicate with staff to facilitate daily department functions.

Review analyses of activities, costs, operations and forecast data to determine progress toward stated goals and objectives. Promote compliance with federal and state regulations and contractual agreements. Develop, implement and maintain compliance, policies and procedures regarding medical utilization management functions. Develop, implement, and maintain utilization management programs to facilitate the use of appropriate medical resources and decrease health plan financial exposure. Compile and review multiple reports on work function activities for statistical and financial tracking purposes to identify utilization trends and make recommendations to management. Facilitate on-going communication between utilization management staff and contracted providers. Develop staff skills and competencies through training and experience.

Tags: Registered Nurse

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