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Healthcare Utilization Management Associate

2 months ago

Long Beach, California, United States Saviance Technologies Full time

Position Overview:
As a vital member of the Utilization Management team at Saviance Technologies, your primary focus will be on performing inpatient medical necessity assessments and utilization reviews. Your efforts will ensure that our members receive the necessary care in a timely manner.

Key Responsibilities:
Your daily responsibilities will include:

  • Assessing and evaluating members who require hospitalization or medical procedures.
  • Securing prior authorizations to facilitate necessary treatments.
  • Maintaining high standards of productivity and quality within the department.

Team Collaboration:
Your role will also involve participating in team meetings, mentoring new colleagues, and achieving departmental objectives. Building and nurturing professional relationships with both providers and customers will be essential to your success.

Professional Conduct:
It is imperative to conduct yourself with professionalism, fostering effective workplace relationships while adhering to company standards and the Code of Conduct.

Qualifications:
The ideal candidate will possess:

  • 0-2 years of clinical practice experience, preferably in hospital nursing, utilization management, or case management.
  • An active, unrestricted State Nursing license (RN, LVN, LPN) in good standing.