Offer summary
Qualifications:
Active and Unrestricted LVN or RN licensure in New York, Previous LVN/RN experience with Utilization Management preferred, General knowledge of UM and Managed Care is desirable, Familiarity with InterQual guidelines is a plus, Proficiency in utilization management programs.
Key responsabilities:
- Evaluate the appropriateness and quality of referral requests
- Provide utilization management services for patients with catastrophic illnesses
- Serve as a clinical resource for various departments
- Handle pre-authorization areas and skilled nursing facility review
- Manage multiple priorities in a fast-paced environment