Utilization Review Specialist Senior

Baycare Health System, Inc Clearwater , FL 33755

Posted 3 weeks ago

The Senior Utilization Review Specialist functions as the primary liaison between the funding agents and all other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services. The Senior Utilization Review Specialist is responsible for the oversight of the utilization Review Specialists.

Perform other duties as assigned by the supervisor. Critical Care or Emergency Nursing RN preferred.

Certifications and Licensures

RequiredRN (Registered Nurse)PreferredUtilization Management


ExperienceRequired2 years

Utilization ReviewOr4 years

Registered NursePreferredReference summary for details

Specific SkillsRequiredCustomer service skills

RequiredWritten and verbal communication skills

RequiredInterpersonal skills

RequiredWork with a team

RequiredCritical thinking skills

RequiredKnowledge of regulatory standards appropriate to position

RequiredWork independently

RequiredDelegation skills

RequiredComputer skills appropriate to position

RequiredOrganizational skills

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Utilization Review Specialist Senior

Baycare Health System, Inc