Healthcare Utilization Specialist
3 weeks ago
Madison County Memorial Hospital is a critical access hospital serving the community with compassionate and high-quality care. We are currently seeking a skilled Healthcare Utilization Specialist to join our team.
About the Role:
The Healthcare Utilization Specialist will be responsible for reviewing and authorizing healthcare services to ensure they are medically necessary and align with established guidelines. This individual will work closely with healthcare providers to ensure that patients receive evidence-based care.
Key Responsibilities:
- Review medical records and clinical data to determine medical necessity of services
- Analyze data to identify trends and opportunities for improvement
- Collaborate with healthcare providers to develop and implement cost-effective care plans
- Stay up-to-date on changing regulations and guidelines related to healthcare utilization review
Requirements:
- Florida licensed Registered Nurse or Practical Nurse required
- Minimum 2 years acute care nursing experience preferred
- One year utilization review/case management/insurance verification/authorization experience required
What We Offer:
- A competitive salary range of $70,000 - $85,000 per year
- A comprehensive benefits package, including health insurance, retirement plan, and paid time off
- The opportunity to work with a talented and dedicated team of healthcare professionals
How to Apply:
Please submit your application, including your resume and cover letter, to [insert contact information]. We look forward to hearing from you
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