Overview

Responsible for management of day-to-day operations of the Utilization Review department including evaluation of daily data capture, quality assurance, program implementation, training and management of staff to achieve performance improvement, revenue enhancement and meet the managed care objectives of the company. Manage the daily operational activities of the unit from UR referral receipt to closure. Assist in regulatory audit proceedings within the department including Utilization Review Accreditation Commission (URAC) and state agency audits. Conduct internal file audits to ensure quality UR outcomes. RN license required. CCM Preferred.Minimum 5 years prior operational experience in a managed care / healthcare environment and 1 year workers compensation experience. Advanced analytical and problem-solving skills. Advanced customer service skills. Advanced PC, organization and communication skills. Advanced interpersonal and multi-function staff management skills. Proficient knowledge of state jurisdictional and regulatory issues.About AIGAmerican International Group, Inc. (AIG) is a leading international insurance organization serving customers in more than 130 countries and jurisdictions. AIG companies serve commercial, institutional, and individual customers through one of the most extensive worldwide property-casualty networks of any insurer. In addition, AIG companies are leading providers of life insurance and retirement services in the United States.AIG Property Casualty is a global market leader, one of the few truly global property casualty franchises.AIG Life and Retirement is one of the largest life insurance organizations in the U.S., and provides protection, investment and income solutions needed for financial and retirement security.United Guaranty Corporation is the marketplace leader in mortgage insurance in the U.S.Additional information about AIG can be found at www.aig.com | YouTube: www.youtube.com/aig | Twitter: @AIG_LatestNews | LinkedIn: www.linkedin.com/company/aig