Utilization Specialist
Enterprise Engineering, Inc.
Utilization Specialist
Part time 20 hours a week then will go to a Full Time Opportunity Location: Central Florida; must be willing to travel to Orlando or Villages from time to time (remote, but available for onsite meetings)
Key Responsibilities
Review any new Medicare patients from last 3 months
- Whether new patient is seen or not, this person would:
- Review each new patient's HCCs
- Review their ADTs
- Review eCW/Prisma for documents available from hospitals
- If new patient is already seen, this person will also do the following:
- Review charts and diagnostics
- Specialist visits and referrals we've sent
- Other issues (Smoking, alcohol, SDOH)
- Produces a member-level report outlining KPIs
Required Skills/Experience
Required:
- Moderate clinical background
- MS Excel, Word, PowerPoint
Preferable:
- Strong clinical background
- eCW experience
Vacancy posted 2 days ago
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