Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Hours: M-F 8a-4:30p
NO Remote Work
NO RELOCATION ASSISTANCE AVAILABLE
WeCare is actively seeking a Utilization Review Advocate. This vital role is central to our commitment to delivering exceptional care and support. The ideal candidate will be responsible for overseeing various aspects of utilization management, ensuring adherence to service standards, and collaborating across departments to promote efficient, person-centered care. A key component of this role includes the management of billing reviews and the diligent follow-up on claims denials. We are seeking an individual with insurance billing experience specific to: PCA-in home care, Adult Day Services and other services that WeCare provides to the client base.
Duties to include:
Requirements: