Job Title: Registered Nurses
5 Positions
Job Description:
Registered Nurses will be required to work on medical related projects as below stated
Clinical Duties:-
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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