Utilization Review and Coordination Specialist

3 weeks ago


Woodland, California, United States Dignity Health Full time

Job Description:

We are seeking a skilled Utilization Review and Coordination Specialist to join our team at Dignity Health Medical Foundation. This is a unique opportunity to make a meaningful impact on patient care while working in a fast-paced environment.

Key Responsibilities:

  • Review medical records, benefit guidelines, and other documentation to determine medical appropriateness
  • Collaborate with healthcare professionals to coordinate member care
  • Provide clinical resource support to non-licensed staff
  • Develop and implement processes to improve efficiency and effectiveness

Requirements:

  • Five (5) years of experience as an RN
  • Two (2) years of experience in a medical insurance environment
  • Bachelor's degree (BA or BS) or equivalent education and experience
  • Current California Registered Nurse (RN) license
  • Excellent communication and interpersonal skills
  • Able to work independently and as part of a team

Salary Range:

$46.96 - $68.10 per hour. We offer a competitive salary range and benefits package.



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