Utilization Management Coordinator. Contractor shall have a full-time Utilization Management Coordinator, who shall be (i) a registered nurse licensed in Illinois, or (ii) other professional as approved by the Department based on Contractor’s demonstration that the professional possesses the training and education necessary to meet the requirements for utilization review activities required in the Contract. The Utilization Management Coordinator will manage the pre-authorization and Referral functions, and inpatient certification review staff for inpatient initial, concurrent and retrospective reviews.
Appears in 5 contracts
Samples: www.illinois.gov, www.justiceinaging.org, www2.illinois.gov
