- Molina Healthcare (Jackson, MS)
- **KNOWLEDGE/SKILLS/ABILITIES** + Performs monthly auditing of registered nurse and other clinical functions in Utilization Management ( UM ), Case Management (CM), ... Management (HM), and/or Disease Management (DM). + Monitors key clinical staff for compliance with NCQA, CMS, State and...or related field. **Required Experience** + Minimum two years UM , CM, MAT, HM, DM, and/or managed care experience.… more
- InnovaCare (San Juan, PR)
- …to the Utilization Management Inpatient Coordinator.14. Prepares and submits to the Health Services Department / UM Medical Care Manager a monthly report of ... compliance with the Plan's SNP policies and MOC requirements. Clinical staff who do not complete the required annual...care, on site or telephonically to validate appropriateness of services , lengths of stay and levels of care, utilizing… more
Locations:
Mississippi,
Puerto Rico