Healthcare Utilization Specialist

7 days ago


Wheeling, West Virginia, United States The Health Plan Full time

Job Title: Healthcare Utilization Specialist

Salary: $85,000 - $115,000 per year

The Health Plan is seeking a skilled and compassionate Registered Nurse to join our team as a Healthcare Utilization Specialist. In this role, you will work closely with healthcare providers and patients to ensure that high-quality care is delivered efficiently and effectively.

Key Responsibilities:

  • Reviewing patient cases to determine medical necessity and appropriateness of services
  • Developing and implementing personalized care plans to promote positive health outcomes
  • Collaborating with healthcare teams to ensure seamless care coordination and communication
  • Maintaining accurate records of patient data and progress
  • Providing education and support to patients and their families to empower them to take an active role in their care

Requirements:

  • Bachelor's degree in nursing (BSN) or higher required
  • At least 5 years of experience as a registered nurse in a clinical setting
  • Licensure in Ohio and West Virginia required

Benefits:

  • Competitive salary range of $85,000 - $115,000 per year
  • Ongoing training and education opportunities to enhance clinical skills and knowledge
  • A supportive team environment that encourages collaboration and open communication
  • A comprehensive benefits package, including health insurance, retirement plan, and paid time off


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