Physician Utilization Review Specialist Per Diem

6 days ago


Hackensack, New Jersey, United States Hackensack Meridian Health Full time
Job Title: Physician Utilization Review Specialist Per Diem

Job Summary:

We are seeking a highly skilled Physician Utilization Review Specialist to join our team at Hackensack Meridian Health. As a key member of our clinical team, you will be responsible for ensuring the integrity of clinical records and collaborating with healthcare professionals to manage and resolve utilization review activities.

Responsibilities:

  • Provide direction and support regarding CMS & NJDOH regulations governing Utilization Management & Clinical documentation.
  • Liaise with the Medical Staff to support Utilization Management Committee processes.
  • Review and facilitate appropriate Level of Care Determinations (Inpatient, Observation, Outpatient/Ambulatory).
  • Conduct and/or support improvement and outcomes studies related to Utilization Management.
  • Partner with Operations and Senior Leadership to assess and implement technology.

Qualifications:

  • Medical degree from a recognized Medical School.
  • Completion of a residency program from an accredited medical institution.
  • Minimum of 3 years medical practice experience.
  • Ability to effectively communicate with professional peers, department members and all levels of administration.

Licenses and Certifications:

  • Medical Doctor License.
  • Maintains at least one Medical Board Certification.

About Hackensack Meridian Health:

Hackensack Meridian Health is a leading healthcare organization in the region, committed to delivering high-quality patient care and advancing medical research and education.



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