Mount Carmel Health System
Remote (Columbus, OH, USA)
Employment Type: Full time Shift: Description: Why MediGold? MediGold is a not-for-profit Medicare Advantage insurance plan serving seniors and other Medicare beneficiaries across the United States. We’re dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety of professional roles including information technology, financial analysis, audit, provider relations and more. Position Purpose RN Utilization Review MCHP is responsible for the coordination of the medical care provided to Plan members with Plan providers, the member's family and other resources as appropriate. Assist in the development of the Plan's UM Program and the review of the Plan's Medical Management Plan. What you will do Participates in designated committees and task forces according to the UM Program and at the direction of the Sr. Director of Medical...