Kelly Services is seeking qualified candidates for a Utilization Management Coordinator! This is a direct hire opportunity working for a large healthcare corporation in Richardson, TX.
This position is responsible performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness and quality of medical/surgical services and serving as liaison between providers and Medical and Network Management Divisions. This position reviews service requests, collects clinical and non-clinical data, verifies eligibility, determines benefit levels in accordance to contract guidelines, prepares reports on quality of care, identifies and reports cases, and provides information regarding utilization management requirements and operational procedures to members, providers and facilities.
• Registered Nurse (RN) with valid, current, unrestricted license in the state of operations.
• 3 years of clinical experience in a physician office, hospital/surgical setting or health care insurance company.
• Knowledge of medical terminology and procedures.
• Verbal and written communication skills.
• Willingness and ability to travel
PREFERRED JOB REQUIREMENTS
•Utilization Management or Case Management experience, highly desired
•In-patient experience, highly desired
•Specialty - O/R, Cardio, etc.
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As a workforce advocate for over 70 years, we are proud to directly employ nearly 500,000 people around the world and have a role in connecting thousands more with work through our global network of talent suppliers and partners. Revenue in 2017 was $5.4 billion. Visit URL blocked - click to apply and connect with us on URL blocked - click to apply, URL blocked - click to apply and URL blocked - click to apply.
Kelly Services is an equal opportunity employer including, but not limited to, Minorities, Females, Individuals with Disabilities, Protected Veterans, Sexual Orientation, Gender Identity and is committed to employing a diverse workforce. URL blocked - click to apply