Healthcare Utilization Specialist

6 days ago


North Chicago, Illinois, United States Decypher Full time

At Decypher, we are committed to delivering innovative solutions and services to our clients. As a leading integrator of professional, technology, and management solutions, we strive to provide exceptional results through collaboration and dedication.

Estimated Salary: $85,000 - $110,000 per year

We are currently seeking a Healthcare Utilization Specialist - Traumatic Brain Injury to join our team. In this role, you will develop and implement comprehensive utilization management plans to optimize healthcare resources.

Responsibilities:
  • Develop and implement utilization management plans to ensure efficient use of healthcare resources
  • Analyze data and metrics to identify trends and areas for improvement
  • Monitor specialty care referrals for appropriateness and compliance with regulations
  • Review medical care practices to identify patterns and trends
  • Act as referral approval authority for designated referrals
Qualifications:
  • Bachelor's Degree in Nursing (BSN)
  • Registered Nurse License
  • Minimum of two years of inpatient medical-surgical experience or acute rehabilitation within the last three years
  • Certification in Case Management or related field (obtain within 6 months)
  • Basic Life Support (BLS) certification
  • US Citizen

We offer a dynamic work environment and opportunities for growth and development. If you are passionate about delivering exceptional results and making a difference in the lives of others, we encourage you to apply.



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