Job Opportunities

Under general supervision, coordinates and administers all aspects of the credentialing process for physicians, professional providers, and network practitioners. Initiates and coordinates the reappointment process for existing providers within assigned areas; ensures accuracy and completeness of all documentation; serves as initial point of contact to providers on day-to-day credentialing issues.

Role expectations for Utilization Management Nurse includes assessing, organizing, implementing and evaluating the care and utilization across the continuum, to enhance quality patient care while simultaneously promoting cost effective resource utilization. This role performs utilization management, discharge planning, and screens for case management referrals. The Nurse assesses the needs of patients/clients and their significant others, while being aware of outcomes, costs, and processes. The nurse combines the roles of clinician and educator to accomplish desired clinical outcomes.