Mass Utilization Review Specialist

This job has been removed
Location: Remote
Compensation: To Be Discussed
Reviewed: Fri, May 09, 2025
This job expires in: 8 days
Resource Coordination Medical Necessity Utilization Management Case Management

Job Summary

A company is looking for a Mass Utilization Review professional.

Key Responsibilities
  • Facilitate resource coordination to help patients achieve optimal health and access to care
  • Manage the medical necessity process for accurate and timely payment for services
  • Ensure compliance with regulatory requirements and provide education on covered services
Required Qualifications
  • Associate's Degree or College Diploma
  • Experience in utilization management or case management
  • Knowledge of state and federal regulatory requirements
  • Familiarity with payer negotiation processes
  • Understanding of TJC accreditation standards
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