WebDec 28, 2024 · Clinical guidelines approved by the Medical Policy & Technology Assessment Committee are available for general adoption by plans or lines of business … WebThe Clinical Review Nurse I is responsible for reviewing and making medical determinations as to whether a claim meets the benefits the member carries. Primary …
Elevance Health Utilization Review Nurse Salaries Glassdoor
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Dr. Shawn Green, DNP - Clinical Nurse Specialist in Atlanta, GA ...
WebUtilization Management Nurse. 12/2011 - 07/2016. New York, NY. Confers with physicians and Physician Advisors when medical record documentation fails to meet criteria. Collaborates with Care Coordinator to assess patient's clinical course and verify need for acute hospital level of care or medical stability for care at the next level. WebClinical Review Nurse I Anthem 3.6 Indianapolis, IN 46201 +4 locations Full-time Day shift + 1 Prior experience with claim review helpful. Two (2) years of clinical experience. … WebWorking knowledge in and successful application of basic level of health care data analysis and clinical review Excellent organizational skills and ability to successfully prioritize multiple tasks Ability to medically review; chart audits, and quality improvement processes Strong attention to detail Ability to provide good customer service skills curtis stone marriage