
Virtual Utilization Manager
3 days ago
Job Title: Virtual Utilization Manager
We are seeking a skilled Virtual Utilization Manager to join our team. The ideal candidate will possess strong analytical skills, excellent communication abilities, and experience in healthcare.
The Virtual Utilization Manager will be responsible for assessing and interpreting customer needs, requirements, and medical records. They will review medical claims for medical necessity and provide recommendations for improvement.
Key Responsibilities:
- Assess and interpret customer needs, requirements, and medical records.
- Review medical claims for medical necessity and provide recommendations for improvement.
- Collaborate with cross-functional teams to develop and implement process improvements.
- Maintain accurate and up-to-date records of customer interactions and medical claims.
Requirements:
- Active PHRN and USRN Mainland License.
- 1 year Bedside experience, preferably with UR/UM experience but not required.
Benefits:
- Opportunity to work from home.
- Competitive salary package.
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