Utilization Management Specialist

Job Summary

A company is looking for a Utilization Management Specialist.

Key Responsibilities

• Initiate and track referral authorizations and gather necessary information for processing
• Act as a liaison between providers, patients, and health plans to support Utilization Management processes
• Document patient information in electronic health records and assist in appeals of denied requests

Required Qualifications, Training, and Education

• Experience in healthcare administration or a related field
• Knowledge of health plan agreements and insurance products
• Familiarity with electronic health record systems
• Ability to work in a remote setting with a structured schedule
• Experience in customer service or member services in a healthcare setting