Job Title: Registered Nurses
Registered Nurses will be required to work on medical related projects as below stated
1) Perform Utilization Management (UM) reviews in accordance with mandated regulations. Maintains compliance with regulatory changes affecting UM.
2) Perform UM reviews (prospective/concurrent/retrospective) for inpatient and outpatient services according to the prescribed standards and client requirements and/or policies.
3) Review UM requests for services against established clinical review criteria, referring cases not meeting criteria to a physician reviewer or prescribed escalation protocol.
4) Adheres to Department …
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