ApplyBlast uses AI to match you with the right jobs, tailor your resume and cover letter, and apply automatically so you can land your dream job faster.

Features

Auto Apply Resume Optimizer Cover Letter Optimizer Interview Prep

Company

Social Media

Need Help?

team@applyblast.com

Case Manager - Utilization Review Specialist at Jobgether - ApplyBlast

Case Manager - Utilization Review Specialist

Jobgether

2 days ago

Remote

Full Time

Senior

0 applicants

View Job Listing

Apply to 100+ jobs

About this role

The Case Manager - Utilization Review Specialist conducts admission and concurrent utilization reviews to assess medical necessity and treatment appropriateness. The role involves analyzing patient records, coordinating appeals for reimbursement denials, and collaborating with clinical teams and payers to resolve complex cases. This position requires maintaining accurate documentation and ensuring compliance with healthcare regulations and privacy standards.

Responsibilities

Conduct admission and concurrent utilization reviews to assess medical necessity and treatment appropriateness
Coordinate first through third level appeals and draft professional appeal letters with clinical evidence
Analyze patient medical records and insurance requirements to determine reimbursement eligibility and prevent denials

Skills

Qualifications

Registered Nurse (RN) license

About Jobgether

jobgether.com

Headquarters

Brussels, Belgium

Company Size

11-50 employees

Founded

2020

View Profile

Jobgether is a remote job platform and career tool designed specifically for senior professionals with 10+ years of experience. It uses AI-powered matching to surface relevant remote and flexible roles, providing match scores, CV review, LinkedIn optimization, and one-click auto-apply. The platform also offers networking guidance and career coaching to help experienced professionals improve their positioning and land the right opportunities faster.