Clinical Utilization Coordinator
3 days ago
Job Summary:
This position is responsible for performing initial and concurrent review activities, discharge care coordination, and serving as a liaison between providers and medical and network management divisions.
Key responsibilities include collecting clinical and non-clinical data, verifying eligibility, determining benefit levels, and preparing reports on quality of care.
The ideal candidate will have a strong background in medical terminology and procedures, excellent verbal and written communication skills, and the ability to travel.
Requirements:
- Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations
- 3 years of clinical experience in a physician office, hospital/surgical setting, or healthcare insurance company
- Knowledge of medical terminology and procedures
- Verbal and written communication skills
- Willingness and ability to travel
Preferred Requirements:
- RN with compact license
- Utilization management experience
- MCG Certification
Work Schedule:
Monday through Friday, 9:30 AM to 6:00 PM
HCSC Employment Statement:
HCSC is an Equal Opportunity Employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
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