Manager, Utilization Management - Must have a MA RN License
CareSource$83K – $133K per yearUnited States only
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Job Summary:
The Manager, Utilization Management is responsible for the oversight of all utilization management activities ensuring consistency of services and achievement of utilization targets.
Essential Functions:
Assist in coordination and management of the pre-determination process of medical and dental services; ensure the consistent application of criteria for authorization decision, and that decisions to deny or reduce services are made by a health care professional who has appropriate clinical expertise