Utilization Management Specialist-MSH-Case Management-FT-Days

**Job Description**

This position is responsible for coordinating requests for clinical information from third party payers and providing support to a broad client base, both internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay. This position also facilitates and tracks concurrent adverse determinations and collaborates with Appeals Management Department in managing retrospective denials.

**Qualifications**

+ Associates degree or equivalent combination of experience (Bachelors preferred).
+ 2 or more years of relevant experience.

**Responsibilities**

1. **Admission: Payer Authorization & Denials Management.** Communicate with payer to obtain request for clinical information, payer authorization and determination _(i.e. frequent communication until case determination is established),_ follows up at regular interval to ensure p...