Utilization Management Specialist

3 days ago


San Diego, California, United States Sharp HealthCare Full time
Job Summary

Sharp HealthCare is seeking a highly skilled and detail-oriented Utilization Management Specialist to join our team. As a Utilization Management Specialist, you will play a critical role in ensuring that patients receive the necessary care and services in a timely and efficient manner.

Key Responsibilities
  • Conduct thorough reviews of patient records to determine medical necessity and appropriateness of care
  • Collaborate with healthcare providers, payers, and other stakeholders to ensure seamless coordination of care
  • Develop and implement care plans that meet the unique needs of each patient
  • Monitor and evaluate the effectiveness of care plans and make adjustments as needed
  • Provide education and support to patients and their families to ensure they understand their care and treatment options
Requirements
  • Bachelor's degree in a healthcare-related field
  • 3+ years of experience in utilization management, case management, or a related field
  • Strong analytical and problem-solving skills
  • Excellent communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize multiple tasks
What We Offer
  • Competitive salary and benefits package
  • Opportunities for professional growth and development
  • Collaborative and supportive work environment
  • Recognition and rewards for outstanding performance


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