RN Utilization Management Reviewer
Sagility(7 months ago)
About this role
The RN Utilization Management Reviewer at Sagility is responsible for clinical and service authorization review for medical necessity and ensuring compliance with CMS standards. This position requires close collaboration with clinical teams to facilitate decision-making processes while maintaining the accuracy and documentation of clinical decisions.
Required Skills
- Utilization Management
- Clinical Review
- Medical Necessity
- InterQual
Qualifications
- RN - Associate’s Degree
- Current RN License
- CCM (Certified Case Manager)
About Sagility
sagilityhealth.comSagility delivers end-to-end healthcare BPO, revenue cycle management, and clinical support services for providers and payers. Explore our full-service model.
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