Utilization Review and Coordination Specialist
3 weeks ago
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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