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Manager Utilization Review RN (remote- previous leadership UR experience in MCO preferred)
JOB SUMMARYThe Manager Utilization Review RN provides leadership, strategic oversight, and monitoring of Utilization Review (UR) staff and programs, including the delivery of care coordination in all lines of business, management of targeted populations, expediting movement of members through appropriate levels of care, the evaluation of programs, improving programs, and creating new programs. Ability to assess and improve workflow and system configuration to meet regulatory and business requirements.ESSENTIAL FUNCTIONS OF THE ROLEĀ
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