Mass Utilization Review Specialist
A company is looking for a Mass Utilization Review professional. Key Responsibilities Facilitate resource coordination to help patients achieve optimal health and access to care Manage the medical necessity process for accurate and timely payment for services Ensure compliance with regulatory requirements and provide education on covered services Required Qualifications Associate's Degree or College Diploma Experience in utilization management or case management Knowledge of state and federal regulatory requirements Familiarity with payer negotiation processes Understanding of TJC accreditation standards
A company is looking for a Mass Utilization Review professional.
Key Responsibilities
Facilitate resource coordination to help patients achieve optimal health and access to care
Manage the medical necessity process for accurate and timely payment for services
Ensure compliance with regulatory requirements and provide education on covered services
Required Qualifications
Associate's Degree or College Diploma
Experience in utilization management or case management
Knowledge of state and federal regulatory requirements
Familiarity with payer negotiation processes
Understanding of TJC accreditation standards
