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Position: Inpatient Utilization Management Specialist
Location: Altoona, WI
Job Id: 1013-1252
# of Openings: 1
Position Purpose
With minimal supervision the Inpatient Utilization Management Specialist assesses, plans, directs, and conducts utilization reviews, discharge planning and transition of care to optimize health care outcomes for our members. Reviews are conducted using evidence-based clinical criteria to determine if admissions and services are medically necessary and a covered benefit under the members health plan. The UM Inpatient Specialist functions as part of an interdisciplinary team. Communicates and documents review determinations in accordance with established policy/procedures, applicable state, federal and accreditation requirements. Relates effectively with others both internally and externally for continuity of care; maintains satisfactory relations with others, maintains accurate and complete records
Essential Position Functions
Minimum Requirements of the Position
This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: resumes@group-health.com. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
Group Health Cooperative of Eau Claire considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
Full Time
Business Services
$72k-94k (estimate)
02/08/2023
06/06/2024
group-health.com
ALTOONA, WI
25 - 50
1976
CLAIRE JOHNSON
<$5M
Business Services
Group Health Cooperative is a community-based non-profit health plan that delivers high-quality, personalized service to its members. The Cooperative started as a local coalition over 30 years ago. While it is still a local plan with a local focus, it is now a nationally recognized HMO serving over 70,000 members in Western Wisconsin.