As Utilization Managers, we lead and direct the utilization review of employees and the healthcare facility’s functioning while ensuring that it complies with the predetermined goals and objectives. We also refer complex cases not meeting the facility’s standard criteria as previously established by the hospital’s management to Physician Advisors for evaluation and follow through with recommendations. We communicate and work with the patient’s insurance provider when required to provide them with in-depth clinical reviews to obtain authorization for hospital stays.
Core tasks:
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