Utilization Management Specialist

Perform ongoing reviews of patient medical records and history to monitor adherence to defined health plan and identify needs for additional care or services.

Keep abreast of subsequent treatment plan while ensuring appropriate and cost-effective healthcare services to patients.

Conducts any pre-certification requirements to evaluate member eligibility.

  • Prior utilization management/review experience is required.‬‬
  • Case Management experience is required, preferably in chronic care.
  • Experience working with Medicaid and/or Medicare managed care, including ‬regulatory and compliance requirements is required.

Open Positions

Business Development Regional Leader Chronic Care Management Nurse Clinical Social Worker Medical Assistant Network Operations Specialist Nurse Practitioner Patient Care Coordinator Recruiter Utilization Management Specialist
Call Us Today:  713-589-5283

7501 Fannin Street, Suite 705, Houston, Texas  |  713-589-5283  |
© 2017, Transtreme LLC, All Right Reserved