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Accountabilities:

  • Assess referred concurrent denials and determine next steps for resolution.
  • Review medical record documentation to support denial management strategies.
  • Collaborate with leadership to optimize payor agreements.

Requirements:

  • Current Registered Nurse license or multi-state Registered Nurse license.
  • Four years of clinical experience in a hospital setting.
  • Three years in Utilization Review or Clinical Appeals.

Benefits:

  • Flexible working hours with remote work options.
  • Opportunities for professional development and training.
  • Collaborative environment with interdisciplinary teams.

Connecticut General

They are currently looking for a Utilization Management Coordinator. By enhancing operational efficiencies and implementing educational initiatives, this role significantly impacts the financial and quality outcomes of healthcare delivery.

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