Utilization Review Specialist
Job Summary: Performs utilization review with external agencies to ensure payment for medically necessary inpatient services.
Minimum Qualifications: Bachelor’s degree or commensurate experience in a related field of Psychology or Utilization Review. Completion of Handle with Care Basic Certification in physical and nonverbal patient management within two months of hire with annual re-certification.
Knowledge, Skills & Abilities: Master’s degree in Psychology, preferred. Previous experience with utilization review, case management or telephone triage desired. Familiarity with electronic medical records and medical terminology.
Working Conditions: Potential exposure to infectious disease.
Physical Requirements: Constantly sit, see/visual acuity, handle/grasp/feel, talk/hear, lift/carry 1 to 25 lbs. Frequently stand, walk, reach, bend/twist, lift/carry 25 to 49 lbs. Occasionally lift/carry 50+ lbs.