The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal and/or state statutes, regulations and guidelines as well as facility policy.
Minimum Requirements:
- Current license for the state in which the nurse practices if nursing licensure is required by contract
- A Bachelor’s Degree in Nursing or at least two years’ experience in Utilization Review preferred
- Certification in Utilization Review or Utilization Management preferred
- Experience with Microsoft Office Suite and the ability to learn new information systems and software programs
- General knowledge of managed care delivery system
- Current CPR if applicable
- TB questionnaire, PPD or chest x-ray if applicable
- Current Health certificate (per contract or state regulation)
- Must meet all federal, state and local requirements
- Must be at least 18 years of age
- Competitive pay & weekly paychecks
- Health, dental, vision, and life insurance
- 401(k) savings plan
- Awards and recognition programs