UMass Memorial Health
1 open remote positions
UMass Memorial Health is the premier health system of Central Massachusetts, with more than 20,000 employees working together as one health system.
Utilization Management Specialist
2 weeks ago
US
The Utilization Management Specialist (UMS) screens patients to determine the appropriate level of care through the use of clinical criteria, the Medicare Inpatient Only List, and individual payer requirements. The Utilization Management Specialist collects data, completes audits, and generates reports based on trends and various improvement initiatives. The Utilization Management Specialist interacts with Care Coordination, Coding, Revenue Integrity, Compliance, Physician Advisors, Physicians, and payers to establish level of care.