Utilization Management Specialist

5 days ago


Singapore Snaphunt Pte Ltd Full time

Company

Snaphunt Pte Ltd

Designation

Utilization Management Specialist

Date Listed

14 Jun 2025

Job Type

Entry Level / Junior Executive
- Full/Perm

Job Period

Immediate Start, Permanent

Profession

Medical / Therapy Services

Industry

Healthcare / Fitness / Sports

Location Name

Singapore

Allowance / Remuneration

$8,000 monthly

Company Profile

Our client specializes in Healthplan IT solutions, offering a comprehensive suite of services designed to enhance efficiency and improve digital presence for health plans and Third-Party Administrators (TPAs).

**Job Description**:

- Fantastic work culture

**The Job**

Key Responsibilities
- Conduct prior authorization, concurrent, and retrospective reviews for various healthcare services, including inpatient, outpatient, home health, and behavioral health.
- Collaborate with healthcare providers, medical directors, and clinical staff to facilitate appropriate care plans and resource utilization.
- Maintain accurate and organized documentation of all utilization management activities.
- Participate in quality improvement initiatives and assist in developing clinical guidelines.
- Monitor and report on utilization trends to management, identifying areas for improvement.

**Qualifications**:

- Bachelor's Degree in Nursing (BSc Nursing) or equivalent.
- Minimum of 2 years of clinical experience in a hospital or healthcare setting.
- Active and unrestricted Registered Nurse (RN) license in the United States.
- Familiarity with utilization management processes and guidelines (e.g., MCG, InterQual).
- Proficient in medical terminology, anatomy, and physiology.
- Strong analytical and problem-solving skills.
- Excellent communication skills, both written and verbal.

Preferred Qualifications
- Experience with Medicaid, Medicare, and Managed Care programs.
- Previous experience in utilization review or case management.
- Certification in Case Management (CCM) or Accredited Case Manager (ACM) is a plus.

**Ref: XCEUUZP01Z**

Application Instructions

Agent Note This position is posted on behalf of a client by a third party agent.



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