Medical Review Specialist

5 days ago


Norfolk, Virginia, United States Elevance Health Full time
About Elevance Health

Elevance Health is a leading health company dedicated to improving lives and communities. We strive to make healthcare simpler and more accessible.

Job Overview

We are seeking a highly skilled Medical Review Specialist - Utilization Management to join our team. As a Medical Review Specialist, you will play a critical role in ensuring that healthcare services are provided in a cost-effective and clinically appropriate manner.

Estimated Salary: $65,000 - $85,000 per yearKey Responsibilities:
  • Conduct thorough reviews of medical records to ensure that services are medically necessary and meet established guidelines.
  • Develop and maintain relationships with healthcare providers and facilities to improve health outcomes for our members.
  • Apply clinical knowledge to coordinate care and optimize treatment plans.
  • Collaborate with internal stakeholders to ensure that medical decisions are informed and consistent with organizational policies.
Requirements:
  • A minimum of 2 years of experience in clinical or utilization review, preferably in a managed care setting.
  • An active unrestricted license or certification as a LPN, LVN, or RN to practice as a health professional within the scope of practice in applicable state(s) or territory of the United States.
  • Strong analytical and problem-solving skills, with the ability to interpret complex medical information.
Benefits:
  • A competitive salary range of $65,000 - $85,000 per year.
  • A comprehensive benefits package, including medical, dental, and vision coverage.
  • A generous Paid Time Off policy and opportunities for professional growth and development.
About Us

Elevance Health operates in a Hybrid Workforce Strategy, with a focus on providing flexible work arrangements that balance work and personal life. Our commitment to diversity, equity, and inclusion is reflected in our hiring practices and employee programs. We are an Equal Employment Opportunity employer and welcome applications from qualified candidates who share our values.



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