Utilization Management Specialist
2 days ago
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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