Medical Utilization Analyst Job in Newark, New Jersey US
Job Summary This position is accountable for the detection, investigation, resolution and prevention of utilization abuse and mismanagement of BCBS benefits by providers and subscribers. Assists in the development and implementation of all projects and programs, which support the Plan’s Cost Containment efforts. Job Qualifications Education/Experience: 1. Requires a Bachelor’s degree. 2. Requires a Registered Nurse (RN) license. 3. Requires a minimum of two years clinical experience. 4. Requires a minimum of one year business/insurance experience with Utilization Review or medical Read more […]