Job Description

The Utilization Review Specialist is responsible for the assessment and review of the healthcare delivery system with a concentration on tasks that promote cost-effective quality care and cost containment in accordance with various federal and/or state statutes, regulations and guidelines as well as facility policy.

Minimum Requirements:


+ Current license for the state in which the nurse practices if nursing licensure is required by contract

+ A Bachelor’s Degree in Nursing or at least two years’ experience in Utilization Review preferred

+ Certification in Utilization Review or Utilization Management preferred

+ Experience with Microsoft Office Suite and the ability to learn new information systems and software programs

+ General knowledge of managed care delivery system

+ Current CPR if applicable

+ TB questionnaire, PPD or chest x-ray if applicable

+ Current Health certificate (per contract or st...

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