…or services (with complete cost/benefit analysis). Oversees all CQI and utilization review activities. Assists in agency evaluation activities. Participates

…plans/care paths are addressed and met. Serve as liaison to ancillary and utilization review services, serve as communication link between health team members.

…(2) years acute care and/or community health nursing + Preferred prior insurance /managed care/ utilization review experience in the role of a Case Manager or

…mental health/crisis intervention experience required. Previous experience with case management/ utilization review and managed care models preferred. Please

…years of strong clinical experience in a clinical practice area + Knowledge of utilization review and InterQual (CRH provides training & time to acquire

…and experience in the practice of Dentistry. + Experience with professional claim ( utilization ) review is highly preferred. Knowledge of the community standards

…measures including sentinel event review . + Actively participant of the Utilization Review process and follow proper procedures. + Provides appropriate

…applies to Acute Care setting preferred) **Job Details** Department: HPTE SNF Utilization Review Standard Hours Per Week: 75.00 Weekend/Holiday Requirement: No

…post residency/fellowship + Knowledge of applicable state federal laws + Utilization Review Accreditation Commission and National Committee for Quality

…research psychology, industrial psychology, organizational psychology, health psychology, utilization review , guidance counseling, pastoral counseling, or