Clinical Utilization Specialist
1 day ago
Job Summary:
The Clinical Utilization Specialist will evaluate patient care and activities against objective criteria to take a proactive approach in addressing admission status. This role will identify utilization issues, resolve and/or refer them in accordance with established procedures.
Responsibilities:
- Evaluate patient care and activities against objective criteria
- Identify utilization issues and resolve or refer them
- Review medical records to determine appropriateness and medical necessity of admission and hospital stay
- Use working knowledge of clinical EMR system
Requirements:
- Bachelor's Degree in Nursing within 3 years of hire
- 2 years of clinical experience in acute care or managed care setting
- Current state license as Registered Nurse
Preferred Qualifications:
- Working knowledge of Microsoft Office applications
About OSF HealthCare:
OSF HealthCare is an Equal Opportunity Employer.
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