Clinical Utilization & Care Coordination Specialist

Central Maine Medical Center; Lewiston (ME); On-site; USD 39,000 - 60,000; Full time

Job summary

Central Maine Medical Center in Lewiston, ME, is seeking a reviewer to coordinate and complete clinical reviews of patient records and support case management within Utilization Review. You will collaborate with leadership to ensure compliant discharge planning and timely patient care.

Qualified candidates hold MPH or related health field and medical (or dental) degree, with knowledge of pathophysiology and pharmacology, plus strong communication and data-entry skills.

Qualifications

• MPH or related health care field required.
• Medical or Dental Graduate required.
• Knowledge of Clinical Pathophysiology and Pharmacology required.

Responsibilities

• Coordinate and complete clinical reviews for patient medical records.
• Participate in Case Management and UR meetings.
• Educate departments on related processes.
• Review patient charts to assess admission criteria and continuation of treatment.
• Coordinate discharge referrals as requested by staff and families.
• Maintain knowledge of Federal, State, and intermediary guidelines for inpatient care.

Skills

Clinical pathophysiology

Pharmacology

Communication skills

Critical thinking

Interpersonal skills

Independent work

Typing 35 wpm

10-key data entry

Education

Master of Public Health (MPH) or related health care field

Medical or Dental Graduate

Job description

Central Maine Medical Center in Lewiston, ME, is seeking a reviewer to coordinate and complete clinical reviews of patient records and support case management within Utilization Review. You will collaborate with leadership to ensure compliant discharge planning and timely patient care.

Qualified candidates hold MPH or related health field and medical (or dental) degree, with knowledge of pathophysiology and pharmacology, plus strong communication and data-entry skills.