
Utilization Management Specialist
1 week ago
Our organization is seeking a highly skilled Utilization Management professional to join our workforce. As a key member of our process, you will be responsible for assessing and interpreting customer needs, requirements, and medical records.
Key Responsibilities:
- Review medical claims for medical necessity
- Analyze patient data and identify areas for improvement in care coordination
- Collaborate with healthcare professionals to ensure accurate and timely processing of medical claims
- Develop and implement effective utilization management strategies to improve patient outcomes
Requirements:
- Active PHRN and USRN License
- Minimum 1 year bedside experience, preferably with UR/UM experience but not required
What We Offer:
- A dynamic work environment
- Ongoing training and development opportunities
- The chance to make a meaningful difference in the lives of patients
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