UM Regulatory Nurse Specialist, Health New England R40652 - Springfield, MA
3 weeks ago

Job summary
The UM Regulatory Nurse Specialist is responsible for delivering medical or behavioral health utilization management (UM) and coordination of care services to members in compliance with current accreditation requirements and quality standards,Responsibilities
- Pre-authorization review utilizing criteria to determine appropriateness of requested services
- Admission review utilizing criteria to determine appropriateness of inpatient admission
Job description
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