Job Summary
A healthcare company is searching for a person to fill their position for a Remote Utilization Management Professional in Orlando.
Core Responsibilities Include:
- Developing and managing new enrollee transitions
- Reviewing planned, in process, or completed health care services
- Providing information to enrollees, providers, and internal staff
Applicants must meet the following qualifications:
- Must be flexible to work one or two weekends monthly
- Associates: Nursing
- Licensed Practical Nurse - Care Management
- Registered Nurse, State and/or Compact State Licensure
- 3 years experience post degree in a clinical, psychiatric and/or substance abuse health care setting
- 3 years of experience conducting utilization management according to medical necessity criteria
