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Utilization Review Specialist, Senior

The Senior Utilization Review Specialist functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services. The Senior Utilization Review Specialist is responsible for the oversight of the utilization Review Specialists. Perform other duties as assigned by the supervisor.Certifications and LicensuresRequiredRN (Registered Nurse)PreferredUtilization Management
EducationRequiredAssociate'sNursingOrDiplomaNursingPreferredBachelor'sNursing
ExperienceRequired2 yearsUtilization ReviewOr2 yearsRegistered Nurse
Specific SkillsRequiredCustomer service skillsRequiredWritten and verbal communication skillsRequiredInterpersonal skillsRequiredWork with a teamRequiredCritical thinking skillsRequiredKnowledge of regulatory standards appropriate to positionRequiredWork independentlyRequiredDelegation skillsRequiredComputer skills appropriate to positionRequiredOrganizational skills

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