Utilization Management Specialist

Responsible for managing non-clinical reviews, the full-time remote Utilization Management Specialist will write denial letters for medical necessity, participate in staff training, and assist in resolving claims discrepancies. Key responsibilities Writes and edits all denial letters for medical necessity Participates in training programs for new staff and assists in training existing employees on new procedures Conducts staff audits and manages monitoring tools to ensure quality of work by coordinators Required qualifications Bachelor's Degree or equivalent relevant work experience Minimum of 3+ years of experience in a managed care or health industry environment Proficiency in performing data entry tasks in multiple applications Ability to manage multiple priorities and operate within a sensitive framework Strong organizational and conflict resolution skills