Serve as liaison between hospital inpatient and ambulatory services and managed care organizations. Obtain authorizations for levels of care, perform medical necessity reviews, monitor patient benefits, and coordinate with treatment teams, Evaluation and Referral, and Finance while adhering to contractual agreements.
Job Summary & Responsibilities
The UR specialist's primary role is the liaison between the hospitals inpatient and ambulatory services and the managed care organizations. The UR specialist is responsible for a wide range of administrative responsibilities including obtaining authorization for all levels of care, medical necessity review, monitoring of patients benefits and is knowledgeable of SJMC contractual agreements. The UR specialist works closely with numerous depts. within the hospital, from the treatment teams/programs, Evaluation and Referral Dept, and the Finance Dept.
Pay Range
One year experience in Healthcare and/or Managed Care Setting required.
Undergraduate/Bachelor Degree in Human or Health Services required.
$50,000-$60,000
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