Utilization Management Specialist

Job Summary

A company is looking for a Utilization Management Support Specialist I.

Key Responsibilities

• Assists in the physician advisor process for peer-to-peer reviews and supports scheduling and communication of results
• Performs outreach to providers for initial determinations and documents task completion in internal systems
• Participates in operational activities, including data collection, tracking, and analysis

Required Qualifications, Training, and Education

• Experience in healthcare
• Associate degree preferred
• Understanding of health plan benefit structures
• Familiarity with psychiatric/medical terminology
• Initiative and interpersonal effectiveness