| Medical Utilization Review Supervisor Job Description |
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| The following is a full job description for Medical Utilization Review Supervisor. Here are the requirements and responsibilities for Medical Utilization Review Supervisor along with statistics. If after reading this page you determine that Medical Utilization Review Supervisor is not the position you are looking for, you may want to try one of these similar titles: Medical Utilization Review Manager, Medical Utilization Review Director, Medical Utilization Review Specialist I, Medical Utilization Review Specialist II, Medical Utilization Review Specialist III, Medical Utilization Review Senior Manager, Utilization Review Technician, Dental Utilization Review Analyst, Utilization Review Coordinator |
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| Requirements and Responsibilities For Medical Utilization Review Supervisor |
| Supervises the team responsible for evaluating proposed and/or delivered healthcare services to determine if the services meet established health plan coverage guidelines. Receives, reviews, and acts on pre-authorization requests from service providers for medical procedures, treatments, admissions, and medications. Reviews patient and clinical information to ensure compliance with established utilization review guidelines. Refers more complex requests and those that need clinical review to a medical reviewer. May require a bachelor's degree. Typically reports to a manager. Supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/production environments. Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. Typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. |
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| Also referred to as: Healthcare Utilization Review Supervisor |
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| Similar Jobs: Medical Utilization Review Manager, Medical Utilization Review Director, Medical Utilization Review Specialist I, Medical Utilization Review Specialist II, Medical Utilization Review Specialist III, Medical Utilization Review Senior Manager, Utilization Review Technician, Dental Utilization Review Analyst, Utilization Review Coordinator |
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| Level of Education: Medical Utilization Review Supervisor Salaries with No Diploma, Medical Utilization Review Supervisor Salaries with a High School Diploma or Technical Certificate, Medical Utilization Review Supervisor Salaries with an Associate's Degree, Medical Utilization Review Supervisor Salaries with a Bachelor's Degree, Medical Utilization Review Supervisor Salaries with a Master's Degree or MBA, Medical Utilization Review Supervisor Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Business Services, Edu., Gov't. & Nonprofit, Financial Services, Healthcare, Insurance | |
