Healthcare Utilization Specialist
2 days ago
We are seeking a skilled Healthcare Utilization Specialist to join our team in a remote capacity. The ideal candidate will possess an active USRN Mainland License and at least one year of hospital experience.
Key Responsibilities:- Conduct thorough reviews of healthcare services to determine medical necessity and ensure alignment with client requirements and policies.
- Develop and implement effective utilization management strategies to optimize resource allocation and improve patient outcomes.
- Collaborate with cross-functional teams to identify areas for process improvement and implement changes to drive efficiency and quality.
- Stay up-to-date with industry developments and best practices in clinical utilization review.
- An active USRN Mainland License is mandatory.
- A minimum of one year of hospital experience is preferred.
- Strong analytical and problem-solving skills, with the ability to interpret complex data and make informed decisions.
- Excellent communication and collaboration skills, with the ability to work effectively with diverse stakeholders.
This role offers a unique opportunity to leverage your expertise in clinical utilization review and contribute to the development of effective utilization management strategies.
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