Utilization Review and Appeals Case Manager

<div><p style="font-family\:Arial;"></p><p style="font-family\:Arial;"> </p><p class="MsoNormal" style="line-height\:normal;margin-bottom\:0in;"><span style="mso-bidi-font-family\:Calibri;mso-bidi-theme-font\:minor-latin;"><strong>Position Summary</strong></span></p><p class="MsoNormal" style="line-height\:normal;margin-bottom\:0in;"><span style="mso-bidi-font-family\:Calibri;mso-bidi-theme-font\:minor-latin;">This position is responsible for performing utilization management and concurrent review activities to ensure appropriate level of care determinations for patients receiving inpatient, observation, emergency, and outpatient services. The role includes conducting concurrent and retrospective chart reviews to evaluate medical necessity, support authorization processes, and assist with verbal and written appeals related to denied services or length-of-stay determinations for commercial, government, and external payers.</span></p><p class="MsoNormal" style="line-height\:normal;mar...