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Medical Utilization Review Specialist

2 months ago

Laurel, Mississippi, United States South Central Regional Medical Center Full time

About Us
South Central Regional Medical Center is a leading healthcare provider in the region, dedicated to delivering high-quality patient care and exceptional service.

Job Summary
We are seeking a highly skilled Medical Utilization Review Specialist to join our team. As a key member of our utilization review department, you will be responsible for reviewing patient cases, communicating with healthcare providers, and making informed decisions to ensure optimal patient outcomes.

Job Description
The Medical Utilization Review Specialist will be responsible for:

  • Thoroughly reviewing patient cases to ensure compliance with medical review policies and procedures
  • Communicating effectively with healthcare providers, including physicians, nurses, and other hospital staff
  • Developing and implementing effective review plans to ensure optimal patient outcomes
  • Collaborating with other departments to ensure seamless communication and coordination
  • Staying up-to-date with the latest medical trends, technologies, and regulatory requirements

Required Skills and Qualifications
To be successful in this role, you will need:

  • A degree in nursing (RN, LPN, or equivalent) or a related field
  • Experience in utilization review or a related field
  • Strong communication and interpersonal skills
  • Ability to work in a fast-paced environment and prioritize tasks effectively
  • Proficiency in ICD-10 coding and Interqual criteria

Estimated Salary
-$85,000 - $110,000 per year, depending on experience and qualifications.

Why Join Our Team
At South Central Regional Medical Center, we offer a dynamic and supportive work environment, with opportunities for professional growth and development. We are committed to delivering exceptional patient care and improving the health and well-being of our community.