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Utilization Management Specialist

Company: VirtualVocations
Location: Yonkers
Posted on: July 3, 2024

Job Description:

A company is looking for a Utilization Management Specialist (Home-Based) - Prior Authorization.



Key Responsibilities:

Conduct level of care medical necessity reviews within patient's medical records
Perform utilization management activities to ensure compliance with accreditation/regulatory requirements
Collaborate with healthcare team to promote medically necessary resource utilization and fiscal outcomes


Required Qualifications:

Bachelor's degree in nursing preferred
Graduate from a nationally accredited nursing program
Unencumbered registered nurse (RN) license with the State Board of Nursing
Obtain and maintain required department-specific competencies and certifications
Working knowledge of payer standards for utilization management functions

Keywords: VirtualVocations, Yonkers , Utilization Management Specialist, Executive , Yonkers, New York

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