Clinical Utilization Review Specialist

7 days ago


Delray Beach, Florida, United States Staffosaurus Full time
About the Role

At Staffosaurus, we are seeking a highly skilled Clinical Utilization Review Specialist to join our team. As a key member of our healthcare management team, you will play a critical role in ensuring that our clients receive the best possible care while minimizing costs.

Key Responsibilities
  • Conduct thorough reviews of patient records to determine the necessity and appropriateness of medical treatments and services.
  • Communicate with healthcare providers, insurance companies, and other stakeholders to ensure that patients receive the necessary care and that costs are minimized.
  • Develop and implement strategies to reduce healthcare costs and improve patient outcomes.
  • Collaborate with our team to identify areas for process improvement and implement changes to optimize our services.
  • Stay up-to-date with the latest developments in healthcare policy, regulations, and best practices.
Requirements
  • Master's degree in a related field, such as healthcare administration, social work, or nursing.
  • At least 2 years of experience in healthcare utilization management or a related field.
  • Strong analytical and problem-solving skills, with the ability to think critically and make sound judgments.
  • Excellent communication and interpersonal skills, with the ability to work effectively with diverse stakeholders.
  • Ability to work in a fast-paced environment and prioritize multiple tasks and deadlines.
What We Offer
  • A competitive salary and benefits package.
  • The opportunity to work with a dynamic and growing company that is dedicated to improving healthcare outcomes.
  • A collaborative and supportive work environment.
  • The chance to make a real difference in the lives of our clients and patients.


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