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A company is looking for a Utilization Review Clinician - Behavioral Health.Key ResponsibilitiesEvaluate member's treatment for mental health and substance abuse to ensure medical appropriatenessPerform prior authorization reviews and concurrent...

A company is looking for a Nurse Auditor.Key ResponsibilitiesPerform charge audits and assessments to resolve incorrect or missing chargesMonitor revenue loss reports and identify documentation needs to support charge captureEducate stakeholders...

A company is looking for a Utilization Management Nurse.Key ResponsibilitiesCoordinate and facilitate correct identification of patient statusConduct concurrent and retrospective reviews and support the medical necessity denial and appeal...