Steinway Consulting

Borivali, Mumbai

Nursing Graduates for Utilization Management Specialist/Prior Authorization Specialist - NIGHT SHIFTJob Title:Utilization Management Specialist/Prior Authorization SpecialistJob Description:We are looking for a motivated and detail-oriented Utilization Management Specialist to join our team. As a fresher In this role, you will help review medical information to ensure that healthcare services are necessary and follow best practices. You will support the approval of healthcare services to ensure they are cost-effective and meet patient needs.Preferred SkillsFamiliarity with MCG/Inter Qual Guidelines is a plus.Keep up-to-date with regulations and maintain organized records of all activities.Experience with Medicaid, Medicare, and Managed Care is helpful.Strong knowledge of anatomy, physiology, and medical terminology.Proficient in MS Office applications.Excellent communication skills and ability to work both independently and in a team.Strong analytical and problem-solving skills.Key Functions:Review outpatient procedures, inpatient admissions, home health, and behavioral health services to check if they are necessary.Work with providers and medical directors to get prior authorization and plan for case reviews when needed.Collaborate with clinical staff to ensure appropriate care and resource use.Participate in quality improvement projects and help develop clinical guidelines.Monitor and report on utilization trends to management.Qualifications :Candidates with aBachelor's Degree in Nursingare eligible to applyFreshers also can apply.Candidates already havingwork experience in Hospital Fieldis added advantage.Preference : Female/ Male Candidatescan apply.Shift :Day Shift 8AM to 5PM / Night Shift 9 PM TO 6 AMLocation:Chennai, OMRNo of Openings: 5Perks and BenefitsFive Days of workingSaturday and Sunday fixed Week offDouble Wages (If working on Saturday/Sunday)Both 2 way Cab facility