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Utilization Reviewer
Job DescriptionUtilization Reviewer - Case ManagementFull-time / Day-shift (Primarily Mon-Fri; 9a-5:30p or 10a-6:30p; Occasional weekends/holidays may be necessary. This is a fully onsite position.)UM Capital Region Health - Largo, MD General SummaryUnder general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patient's need for outpatient or inpatient care as well as the appropriate level of care. The role requires interfacing with the case managers, medical team, other hospital staff, physician advisors and payers.
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