Utilization Case Manager

Job Summary

To support optimal patient outcomes, the full-time remote Utilization Case Manager will complete ongoing reviews for clinical utilization, coordinate with the healthcare team, and manage a designated patient caseload while ensuring continued authorization for services.

Key responsibilities

• Perform timely reviews for services requiring authorization for continuation of care
• Facilitate interdepartmental communication regarding authorization status and potential treatment delays
• Maintain knowledge of payer reimbursement policies and clinical guidelines

Required qualifications

• Bachelor's degree in a relevant field or equivalent experience
• Minimum of 2 years of relevant experience