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Piedmont Healthcare Inc.

Mgr Utilization Mgmt-System

Posted 4 days ago

United States

5-10 years experience

medical

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AI Summary

The manager will provide system-level oversight of utilization management activities. This includes ensuring effective review processes and managing professional staff.

Overview

System level matrix over site of the utilization management activities

Responsibilities

System level matrix over site of the utilization management activities

Qualifications

Education

Graduate from a recognized, accredited school of nursing Required

Work Experience

5 years of experience with acute hospital utilization management and review processes, using medical necessity criteria (InterQual and/or Milliman), to include two (2) years of management experience of professional staff Required

Licenses and Certifications

RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Current Georgia RN licensure Upon Hire Required and
IQCI certification Upon Hire Required