
Utilization Management Specialist
1 week ago
We are currently seeking a skilled Utilization Management Specialist to join our team.
- A thorough understanding of medical claims and medical necessity is required for this role.
- Excellent analytical and communication skills are essential to succeed in this position.
Key Responsibilities:
Job Description:
Our ideal candidate will have experience in assessing and interpreting customer needs, requirements and medical records. They will be responsible for reviewing medical claims for medical necessity, ensuring that patients receive the necessary care while minimizing costs.
Required Skills and Qualifications:
To be successful in this role, you will need to possess the following skills and qualifications:
• Active PHRN and USRN Mainland License
• 1 year Bedside experience, preferably with UR/UM experience but not required
Benefits:
This is a work-from-home opportunity with a competitive salary package. As a valued member of our team, you will enjoy a range of benefits including:
• Work from home flexibility
Why Choose Us:
We offer a dynamic and supportive work environment that fosters growth and development. Our company values its employees and strives to provide opportunities for professional advancement.
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