Corizon Health Utilization Management Specialist - Brentwood, TN in Brentwood, Tennessee
We have an exceptional opportunity for a Utilization Management Specialist to join our Healthcare Support Team inBrentwood, TN.
WHAT YOU WILL BRING TO US:
You will have 3-5 years experience in utilization management, case management, quality management. You will have experience with InterQual and/or Milliman Care guidelines. Strong organizational and time management skills. Experience with both Inpatient and Outpatient review process preferred. You will know how to work within computer systems such as spreadsheets, email, and medical records systems.
WHAT OUR EXPECTATIONS ARE FROM YOU:
We need you to be responsible for the implementation of a comprehensive outpatient/inpatient review process utilizing criteria based review standards and standards of best practice.
A facilitator of quality health care intervention recommendations.
Ability to manage a variety of caseload situations and maintain the caseload, as required. Review and assess over/under utilization issues. Track, trend and evaluate appropriateness and quality of care issues with the implementation of education to internal and external customers and process improvement initiatives.
Respond to inquiries by provider/site employees relating to standards of care and best practices.
Highly competent with working relationships UM Medical Directors/contract Medical Directors. Develop and maintain pre-established review parameters under UM Medical Director/contract Medical Director lead. Identify and document comparisons with community standards, regionally based as indicated.
Communicate and document any issues relating to the outpatient/inpatient UM process to the Manager of Utilization Management. Assist with the data collection and reporting related to the UM outpatient/inpatient process. Participate in CEU offerings/seminars to enhance professional growth and development and the maintenance of nursing license.
HOW WE TAKE CARE OF YOU:
Paid Time Off
Medical, Dental and Vision Insurance
401(k) with company match
Corizon Health provides patients with high quality healthcare and reentry services that will reduce recidivism and better the communities where we live and work. We are dedicated to meeting the needs of the growing number of incarcerated persons with physical and mental illness and the professionals who care for them. More healthcare professionals are finding the stability and advancement they desire at Corizon Health.
This position may require a background check, security clearance, and/or drug screening.
Corizon Health is an Equal Opportunity Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status.
Job ID : 14972