
Clinical Utilization Manager
22 hours ago
Utilization Management Specialist
About the Role:
We are seeking a highly skilled Utilization Management specialist to join our team. The ideal candidate will have expertise in assessing and interpreting customer needs, requirements, and medical records.
Key Responsibilities:
- Review medical claims for medical necessity.
- Develop and implement effective utilization management strategies to ensure optimal patient outcomes.
Required Skills and Qualifications:
- Active PHRN and USRN Mainland License.
- 1 year of bedside experience, preferably with UR/UM experience but not required.
Work Environment:
Remote work option available.
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