#UTILI50630

Utilization Review (UR) Clinical Specialist - FT

2021-06-16
  • Organization

  • ShorePoint Health - Port Charlotte ShorePoint Health - Port Charlotte

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  • Full Time

Job Description

Utilization management is the analysis of the necessity, appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures that an authorization for services is obtained from payer, if required, and that documentation supports the care delivered in such a way that minimizes the risk of denials after discharge. remote work from home position

Utilization management is the analysis of the necessity, appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures that an authorization for services is obtained from payer, if required, and that documentation supports the care delivered in such a way that minimizes the risk of denials after discharge.

Continuous sitting, standing, and walking required. Works in a clean, well-lighted, comfortable room temperature that is conducive to a productive work environment. The Employee is not substantially exposed to adverse environmental conditions and; therefore, job functions are typically performed under conditions such as those found within general office or administrative work.

Available as a remote (work from home) position

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