Utilization Review Specialist

To support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of Utilization Management and Independent Review requests remotely, while maintaining compliance and delivering exceptional client service. Key Responsibilities Review and process Independent Review requests for potential conflicts of interest Request and organize additional medical documentation for Physician Advisors Ensure all work meets Client, State, Federal, and URAC compliance standards Required Qualifications High school diploma or equivalent required Minimum of 1 year in a healthcare-related setting Knowledge of HIPAA rules and regulations required Prior experience in utilization review, medical management, or insurance preferred Proficiency in Microsoft Office Suite (Word, Excel, Outlook)