Offer summary
Qualifications:
1-2 years' experience in UM, NY State License as LPN or RN, Experience with MCG guidelines, Familiarity with Medicaid/MLTC members.Key responsabilities:
- Conduct clinical reviews for MLTC members
- Handle denials and partial denial notifications
- Manage personal queue and productivity expectations
- Participate in interdisciplinary teams (IDTs)
- Meet performance goals of 30 cases daily after training