Who we are:
Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.
We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.
Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.
A Day in the Life of a Utilization Management Pre-Service Review Nurse:
This position is responsible for specific functions within the Utilization Management Department including, orientation and training of new utilization management staff, monitor and report progress of new member training, provide staff training for new and updated policies and procedures, perform user testing for new MCS applications/functionality, monitor and optimize staff caseloads, oversee small projects and manage half the case load as expected of a full time case manager. This position also provides first line clinical direction to the utilization management staff and refers to Manager of Clinical Services when necessary.
What you can bring to Meridian:
What Meridian can offer you:
Equal Opportunity Employer