Clinical Care Reviewer-Utilization Management Job at Staffing the Universe, Philadelphia, PA

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  • Staffing the Universe
  • Philadelphia, PA

Job Description

Clinical Care Reviewer Utilization Management

Responsibilities: Under the direction of a supervisor, the Clinical Care Reviewer Utilization Management evaluates medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical documentation, and making determinations based on established criteria.

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