Offer summary
Qualifications:
1-2 years in Utilization Management, Active NY LPN or RN license, Strong computer skills, Familiarity with MCG guidelines, Experience in Medicaid/MLTC reviews.Key responsabilities:
- Conduct standard and expedited UM clinical reviews
- Manage the UM process including denials
- Participate in interdisciplinary team meetings
- Meet productivity goals reviewing 30 cases daily
- Adhere to turnaround times for requests