Licensed LTSS Reviewer

Job Summary

A company is looking for a Long Term Services & Support Reviewer in Utilization Management.

Key Responsibilities

• Conducts care and service needs reviews for Long Term Services and Supports
• Evaluates authorization requests and ensures compliance with medical health benefit policies
• Documents case activities and communicates with service coordinators and providers to facilitate the Utilization Management process

Required Qualifications

• Bachelor's Degree required
• Professional licensure in healthcare or social services-related field preferred
• Registered Nurse licensure is preferred
• Three or more years of experience in a related clinical or social services setting
• Expertise in addressing the needs of the Long Term Services and Support population