…With Us! (https://careers-primehealthcare.icims.com/jobs/177495/social-worker-- utilization - review /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306)

…we are seeking a Registered Nurse or Licensed Social Worker with PSYCH / BH Utilization Review / Utilization Management and knowledge of Interqual / MCG

…Manager (CM) performs a wide variety of tasks and functions. These include utilization review , discharge planning, care coordination and variance management to

…and retrospective review of patient medical records for purposes of utilization review , compliance with requirements of external review agencies

…principal liaison between emergency services, surgical services, nursing, finance, physicians, utilization review and Health Information Management to ensure

…insurance and accommodation type. Contact hospital departments such as Medical Records, Utilization Review , pre billing, financial counselors or external

…Case Managers to assure that the following functions of the role are completed: Utilization Review for medical necessity of admission and concurrent stay, Social

…Experience in the development and management of quality, risk, and utilization review processes. Demonstrated leadership, communication, and analytical skills.

…Licensed Practical Nurse (LPN) Program **Required Experience** + Minimum two years Utilization Review experience. + Knowledge of audit processes and applicable