What are the responsibilities and job description for the Utilization Management RN position at PSG Global Solutions Careers?
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The Opportunity
Description
We're looking for an Utilization Management , working in Insurance industry in Detroit, Michigan, 48226, United States .
- Use established medical policy and guidelines to perform prospective, concurrent, and retrospective medical necessity review of post-acute care services to ensure medical necessity for appropriate setting, appropriate length of stay, including appeal requests initiated by providers, facilities and members.
- Coordinate care through the health care continuum including member outreach.
- Provide support and alternative care support for member not appropriate for post-acute care service as well formulate discharge readiness for members transitioning from a post-acute care setting to a lower level of care.
Our Client
Our client is a fast-growing industry-recognized staffing firm. Recruiting critical IT, Financial, Engineering, Healthcare, and Data Analytics talent. With 20 years' experience and growth.
Connections in Automotive, Healthcare, Retail, Financial & Insurance, and Professional & Business Services. Working to bring top talent together with premier organizations.
Big enough to have great opportunities. Small enough to care about finding the right one for you.
It'sabout relationships based on mutual interest. The results are low turnover, long-lasting partnerships and growth. Want to work for a company invested in your success?
Experience Required for Your Success
What Do You Think?
Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible?
