Director of Utilization Management - Health Plan

at Recruiters Network
Location Bridgewater, MA
Date Posted October 8, 2019
Category Medical Management
Job Type Full-time

Description

RN, state of Massachusetts, BSN preferred. Support goals, contracts, and accreditation requirements of health plan by conducting reviews of clinical interactions and clinical documentation including reviews of case management, utilization management, vendor, and provider records. Provides expert input to finance regarding patterns of utilization and cost and high cost cases....

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