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Inpatient Utilization Review Clinician
2 months ago
Position Overview:
As a vital member of the Utilization Management team at Saviance Technologies, your primary responsibility will be to conduct thorough inpatient medical necessity and utilization assessments. This role is crucial in ensuring that our members receive the appropriate care they require at the right time.
Key Responsibilities:
Your daily activities will include:
- Reviewing and assessing cases of members who require hospitalization or medical procedures.
- Obtaining necessary prior authorizations to facilitate care.
- Maintaining high standards of productivity and quality within the department.
Team Collaboration:
In addition to your review responsibilities, you will participate in staff meetings, mentor new team members, and work towards achieving departmental objectives. Building and maintaining professional relationships with healthcare providers and clients is essential in this role.
Professional Conduct:
It is imperative to conduct yourself in a professional manner, fostering effective workplace relationships while adhering to company standards and the Code of Conduct.
Qualifications:
The ideal candidate will possess:
- 0-2 years of clinical practice experience, preferably in hospital nursing, utilization management, or case management.
- An active, unrestricted State Nursing license (RN, LVN, LPN) in good standing.
