Dec 23, 2016

Utilization Management Specialist

  • EasyHireJobs
  • Hollywood, FL , United States
Full time Business Analysis

Job Description

Hollywood , FL , United States   Provide utilization management / utilization reviews to assure medical necessity of services and care delivery in the appropriate setting as it applies to the clinical care of Health Plan members
- Interact with members providers and vendors on a daily basis
- Collaborate with internal and external departments to ensure the consistent delivery of timely appropriate high quality healthcare.

Job Requirements:

-A minimum of five years of experience in a relevant clinical setting including direct experience with Managed Care utilization and Quality Improvement
-InterQual experience a plus
-Working knowledge of computers required to include Microsoft Office
-Excellent interpersonal and organization skills
-Competent written and verbal communication skills   • EDUCATION: Bachelors Science Nursing Degree (foreign degrees accepted) State Registered Nurse license eligible with equivalent experience


Business Analysis-Research



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