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Clinical Review Specialist I
2 months ago
Position Overview:
As a vital member of the Utilization Management team at Saviance Technologies, your primary focus will be on performing inpatient medical necessity and utilization assessments. This role is essential in ensuring that our members receive the necessary care at the right time.
Key Responsibilities:
Your daily responsibilities will include:
- Reviewing and assessing cases of members who require hospitalization or medical procedures.
- Securing prior authorizations to facilitate timely care.
- Maintaining high standards of productivity and quality within the department.
Collaboration and Professional Development:
In this role, you will also participate in team meetings, mentor new colleagues, and work towards achieving departmental objectives. Building strong professional relationships with healthcare providers and clients is crucial.
Professional Conduct:
It is expected that you conduct yourself with professionalism, foster effective workplace relationships, and adhere to the company’s standards and Code of Conduct.
Qualifications:
The ideal candidate will possess:
- 0-2 years of clinical experience, ideally in hospital nursing, utilization management, or case management.
- An active and unrestricted State Nursing license (RN, LVN, LPN) in good standing.
