UR Case Management Specialist

The UR Case Management Specialist provides leadership in facilitating the treatment process from admission to discharge, acting as a liaison between the organization, third-party payers, and clinical teams to ensure quality patient care and cost-effective outcomes. This role involves monitoring treatment processes, advocating for medical necessity authorizations, and coordinating comprehensive aftercare planning for patients. The specialist collaborates with various departments to resolve care delivery issues, maintain regulatory compliance, and support continuous improvement initiatives within the utilization review department.