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Clinical Utilization Review Specialist

2 months ago

Savannah, Georgia, United States UHS Full time
Job Summary

We are seeking a highly skilled Clinical Utilization Review Specialist to join our team at UHS. As a key member of our healthcare operations team, you will be responsible for ensuring the efficient and effective delivery of healthcare services.

Key Responsibilities
  • Utilization Review: Conduct thorough reviews of patient stays to ensure that services are medically necessary and meet established criteria.
  • Continuum of Care: Collaborate with healthcare providers to develop and implement plans of care that promote optimal patient outcomes.
  • Authorization and Appeals: Ensure that all necessary authorizations are obtained and appeals are processed in a timely and efficient manner.
  • Record Keeping: Maintain accurate and detailed records of all utilization review activities, including patient information and treatment plans.
Requirements
  • Education: Master's degree in nursing, psychology, or a related field.
  • Experience: One to two years of experience in healthcare operations or a related field, with a focus on utilization review and continuum of care.
  • Skills: Strong analytical and problem-solving skills, with the ability to work effectively in a fast-paced environment.
What We Offer
  • Competitive Compensation: A competitive salary and benefits package, including medical, dental, and vision coverage.
  • Opportunities for Growth: Career development opportunities within UHS and its subsidiaries, with a focus on promoting from within.
  • Collaborative Team Environment: A dynamic and supportive team environment, with a focus on collaboration and open communication.