Medical Review Specialist
3 weeks ago
Estimated Salary:$120,000 - $150,000 per year
The University of Texas Southwestern Medical Center is seeking a highly skilled Medical Review Specialist to join our team. As a key member of our healthcare quality assurance team, you will be responsible for conducting medical necessity reviews and ensuring that patients receive the appropriate level of care.
Responsibilities:
- Conduct medical necessity reviews for acute care services
- Use nationally recognized guidelines to recommend levels of care
- Collaborate with physicians and other healthcare professionals to ensure accurate diagnoses and treatment plans
- Identify and record episodes of preventable delays or avoidable days due to failure of progression-of-care processes
Requirements:
- Graduate of an accredited nursing program
- Active unrestricted RN license in the State of Texas
- Minimum 5 years of experience in clinical settings, including 2 years of recent utilization review experience
- Excellent communication and problem-solving skills
Benefits:
- PPO medical plan available day one at no cost for full-time employee-only coverage
- 100% coverage for preventive healthcare – no copay
- Paid Time Off, available day one
- Retirement Programs through the Teacher Retirement System of Texas (TRS)
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