The Judge Group, INC
Judge Healthcare is actively seeking 4 Utilization Management RN's for one of our top clients. This position is on site, office based, located in Wilmington, DE.
This job will have the following responsibilities:
implementation of effective utilization management strategies
review of appropriateness of health care services
application of criteria to assure appropriate resource utilization
identification of opportunities for referral to a Health Coach/case management
identification and resolution of quality issues.
Monitors and analyzes the delivery of health care services; educates providers and members on a proactive basis; and analyzes qualitative and quantitative data in developing strategies to improve provider performance/satisfaction and member satisfaction.
Qualifications & Requirements: Current RN license (any state) REQUIRED
2 years' experience in clinical setting REQUIRED
Utilization Management experience REQUIRED
Proficiency InterQual experience REQUIRED
Two (2) years of any combination of clinical, case management and/or disease/condition management, provider operations and/or health insurance experience REQUIRED
IF INTERESTED AND QUALIFIED, TAKE ACTION NOW AND APPLY!!!!
Please send your MOST UP TO DATE resume to Johann at [Click Here to Email Your Resumé] or give Johann a call at (484) 270-1842.
Thank you so much!!
The Judge Group, INC
Website : http://www.judge.com/
Working at the crossroads of people and transformative technologies, The Judge Group delivers innovative business solutions - powered by top talent - to help organizations reach their strategic goals and realize opportunities now and in the future. The Judge Group is a leading professional services firm specializing in technology, talent, and learning solutions. Our services are successfully delivered through a network of more than 35 offices in the United States, Canada, China, and India. The Judge Group serves more than 40 Fortune 100 companies and is responsible for the placement of more than 5,000 professionals annually across a wide range of industries.