…+ Minimum 3 years nursing experience with a minimum of 1 year in utilization management/ prior authorization review experience. **Experience** : Utilization

…a registry to track all assigned patients and prioritize patients for case review and treatment adjustment. + Recommends any treatment adjustments through the case

…Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and

…etc.). Plans, coordinates and evaluates oral health programs for optimum utilization of service unit resources (eg sealant retention, school-based programs, head

…involve computer system data entry, data management, and reporting. + Review criteria-based prior authorizations following policy and procedure. + Provide on-call

…Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and

…management, including product evaluation, prevention of waste and damage, room utilization , control of overtime, and appropriate staffing mix. 7. Facilitates

…care and cost effectiveness through the integrating and functions of care management, utilization review and discharge planning. The Care Manager must be highly

…location and schedules are subject to change. + Attend certification inspections, utilization review and independent professional reviews as needed. + Attend

…Management activities of the Agency and interface with the hospital. Oversees Utilization Review process. Manages/directs the activities of designated agency