Utilization Management Consultant

Job description

GENESIS HEALTHCARE SYSTEM In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an ‘owner’ of Genesis and keep our patients at the center of everything we do - always. Position Details: Work Shift: Day Shift (United States of America) Scheduled Weekly Hours: 24 Department: Utilization Management Overview of Position: Acts as part of a multidisciplinary team including Genesis Financial and Reimbursement Services, providers, payers, and discharge planners to ensure the patient’s progress across the continuum is efficient, with quality patient care, while promoting cost effective resource utilization. The position is responsible for maintaining hospital compliance with the Quality Improvement Organization (QIO) and CMS guidelines. In addition the position provides case review information to third party payers, assists in the denial and appeals...