Utilization Management Specialist: Improve Care Access

Uloop Inc.; Miami (FL); On-site; USD 50,000 - 70,000; Full time

Job summary

Uloop Inc. is looking for a Utilization Management Coordinator to join our team. This role is crucial for ensuring efficient delivery of healthcare services while managing costs and adhering to regulations.

The coordinator will analyze clinical data, communicate with healthcare providers, and maintain accurate documentation. Candidates should possess a high school diploma and have at least 2 years of relevant experience. Preferred qualifications include an Associate degree in Health Administration and certifications in Utilization Review.

Qualifications

• Minimum of 2 years of experience as a medical assistant or relevant clinical experience.
• Strong knowledge of medical terminology and healthcare regulations.
• Certification in Utilization Review or Case Management is a plus.

Responsibilities

• Review medical records to determine the necessity of requested services.
• Facilitate communication between healthcare providers and insurance representatives.
• Document utilization management activities in compliance with standards.
• Analyze utilization data for trends and process improvement opportunities.

Skills

Knowledge of healthcare regulations

Clinical data analysis

Communication with healthcare providers

Education

High school diploma or equivalent

Associate degree in Health Administration (preferred)

Job description

Uloop Inc. is looking for a Utilization Management Coordinator to join our team. This role is crucial for ensuring efficient delivery of healthcare services while managing costs and adhering to regulations.

The coordinator will analyze clinical data, communicate with healthcare providers, and maintain accurate documentation. Candidates should possess a high school diploma and have at least 2 years of relevant experience. Preferred qualifications include an Associate degree in Health Administration and certifications in Utilization Review.