State Licensed Utilization Reviewer

Job Summary

A company is looking for a Utilization Reviewer 2 who will perform utilization reviews on workers' compensation treatment referrals.

Key Responsibilities

• Perform utilization review to ensure treatment plans are medically necessary
• Collaborate with healthcare providers and stakeholders for comprehensive assessments
• Evaluate medical documentation for compliance with industry standards and regulations

Required Qualifications

• Doctor of Chiropractic (DC) with a valid license in the state of practice
• Minimum of 2 years of clinical experience or an advanced degree without experience
• Knowledge of medical terminology and healthcare guidelines
• Analytical and critical thinking skills for effective decision-making
• Familiarity with relevant software and tools used in healthcare