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The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical review and concurrent review. The Administrative Nurse, LPN's clinical…
The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level. The CRN builds relationships with facility case managers to…
This position serves as Florida Blue Medicare's clinical expert in working with providers, facilities and subscribers in overseeing the well-being of subscribers while ensuring the proper administration of benefits,…
Get To Know Us! WebTPA, a GuideWell Company, is a healthcare third-party administrator with over 30+ years of experience building unique benefit solutions and managing customized health plans. What is your impact? The…
The Medical Director will work closely with the team to perform all types of utilization management (UM) reviews, including but not limited to Pre-service, Post-service, Concurrent Review and Appeals. Key…
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