Utilization Management Specialist

The Denials and RAC Manager at Genesis HealthCare System oversees the strategic management of claim denials and Recovery Audit Contractor (RAC) activities to protect hospital revenue. The role focuses on preparing for RAC audits by developing workflows, policies, communication plans, and maintaining a tracking database for requests and appeals. The position serves as the primary liaison across clinical, case management, and revenue cycle teams to ensure regulatory and documentation readiness.