Clinical Resource Coordinator

6 days ago


Baltimore, United States ALTA IT Services Full time

We are seeking a highly skilled Utilization Management Nurse to join our team at ALTA IT Services. As a leading health insurance customer, we require a UM Nurse to perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage.

This role is an excellent opportunity for a dedicated professional to make a meaningful impact in the healthcare industry. Our ideal candidate will possess strong clinical skills, excellent communication abilities and a passion for delivering high-quality patient care.

The estimated annual salary for this position is $83,000-$110,000, based on national averages for similar roles. Compensation packages may vary depending on location and qualifications.

Job Description:

  • Perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage.
  • Collaborate with healthcare providers, patients and payers to ensure timely and accurate resolution of medical claims.
  • Analyze data and trends to identify opportunities for process improvements and cost savings.

Required Skills and Qualifications:

  • Current licensure as a Registered Nurse (RN) in the United States.
  • Minimum 2 years of experience in utilization management or a related field.
  • Excellent clinical knowledge and critical thinking skills.
  • Strong communication and interpersonal skills.

Benefits:

  • Competitive salary and bonus structure.
  • Comprehensive benefits package, including medical, dental and vision insurance.
  • Retirement plan with company match.
  • Tuition reimbursement program.

Why Join Us:

At ALTA IT Services, we value our employees' contributions and offer a dynamic work environment that promotes growth, collaboration and innovation. We are committed to making a positive impact in the communities we serve and strive to be a leader in the healthcare industry.



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