Licensed Long Term Services Reviewer

A company is looking for a Long Term Services & Support Reviewer in Utilization Management. Key Responsibilities Conducts care and service needs reviews for Long Term Services and Supports (LTSS) requests Documents authorization requests, verifies participant eligibility, and communicates with providers to facilitate the Utilization Management process Applies medical guidelines for decision-making and refers cases to the Medical Director when necessary Required Qualifications Bachelor's Degree required Professional licensure in a healthcare or social services-related field preferred Registered Nurse is preferred Three or more years of experience in a related clinical or social services setting Expertise in addressing the needs of the Long Term Services and Support population

Mar 21, 2025 - 13:42

A company is looking for a Long Term Services & Support Reviewer in Utilization Management. Key Responsibilities Conducts care and service needs reviews for Long Term Services and Supports (LTSS) requests Documents authorization requests, verifies participant eligibility, and communicates with providers to facilitate the Utilization Management process Applies medical guidelines for decision-making and refers cases to the Medical Director when necessary Required Qualifications Bachelor's Degree required Professional licensure in a healthcare or social services-related field preferred Registered Nurse is preferred Three or more years of experience in a related clinical or social services setting Expertise in addressing the needs of the Long Term Services and Support population