Utilization Review Specialist - PACE

The Utilization Management Coordinator will work collaboratively with multiple disciplines, both internal and external to the organization to help provide high quality and cost-effective health management care for patients. Responsibilities include the review and tracking of ED admissions, inpatient hospitalizations, ICF and SNF utilization and specialist appointment utilization in the form of standardized reports which will be generated by the analyst to inform our clinical leadership and health plan regarding utilization trends and potential interventions. This coordination will allow one to work with our interdisciplinary PACE teams, the Inpatient Case Management Coordinator and Providence Health Plan bringing useful insight for ways we can reduce unnecessary resource utilization.