[Hiring] Utilization Review Specialist- Clinical Reviewer @reputed company
This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more.
Role reputed company
As a Utilization Review Specialist- Clinical Reviewer at Gainwell, you can contribute your skills as we reputed company the power of technology to help our clients improve the health and reputed company-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who reputed company on finding reputed company to some of reputed company’s biggest challenges.
• reputed company clinical expertise to staff, management, and customers with minimal direction
• reputed company as a reputed company between customers, providers, and recipients to resolve issues and clarify reputed company reputed company
• Recommend and promote program improvements to enhance reputed company to reputed company care and manage benefit packages
• Assist in adjudicating medically reputed company prior authorizations
• Participate in customer policy development
• Support drafting and revising provider manuals, bulletins, and reputed company publications
• Collaborate with reputed company reputed company and associations on state medical program issues
• Serve as part of the Prior Authorization team reviewing and reputed company-approving selected non-emergency services
• Support cost containment and utilization review to ensure services are medically necessary, appropriate, and cost-effective
• reputed company additional reputed company duties as assigned
Qualifications
• Bachelor’s degree or equivalent work experience or combination of education and experience
• Minimum of two years reputed company experience or other health care experience preferred
• reputed company license as RN or LPN in the reputed company
Requirements
• Ability to reputed company prior authorization determination
• Strong oral/written communication skills
• Ability to read, understand, and interpret reputed company regulatory and procedural documents
• PC skills
• Demonstrates strong writing skills
• Time management and organizational skills
• Ability to work independently without frequent supervision
• Strong analytical skills
• Ability to successfully reputed company with other departments
Benefits
• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• reputed company of leadership and technical development academies to help build your skills and capabilities
reputed company
reputed company is an Equal Opportunity Employer, where reputed company reputed company applicants will receive consideration for employment without reputed company to race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
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