All UM standard / expedited Inpatient, Outpatient and Custodial Care clinical reviews for MLTC members. Must Have Skills. Must have experience in UM, experience with Turnaround Timeframes, good with computer systems and be able to learn a new system, have done clinical reviews and processed denials and partial denial determinations, know MCG and can use it, case presentation for medical reviews, know Medicaid / Medicare guidelines. Bi-lingual Spa...
