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Average Salary
Updated: 05/22/2013
Utilization Review Manager:
Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective review activity. Performs regular data analysis of hospital census, authorization information and medical cost reports to identify variances and root... [+] More
Utilization Review Manager:
Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective review activity. Performs regular data analysis of hospital census, authorization information and medical cost reports to identify variances and root causes so that areas of focus may be identified and resources may be appropriately deployed.
Manages the utilization review function to ensure accurate and timely prior authorization of designated healthcare services, concurrent review, and retrospective review activity. Manages a department responsible for the determination of medical necessity and appropriateness of care based on predetermined criteria and/or guidelines. Plans, organizes, implements and evaluates departmental outcomes. Performs regular data analysis of hospital census, authorization information and medical cost reports to identify variances and root causes so that areas of focus may be identified and resources may be appropriately deployed. Prepares and manages the departmental budget. Hires, develops and motivates a qualified utilization review department staff. Ensures that benefits and policies are properly interpreted and that care is rendered in the most appropriate site of service with a focus on quality care and cost efficient outcomes. Assures timely response to provider requests for services per department standards.
Conducts regular clinical reviews for utilization management activities, based on guidelines and standards for patients in a variety of settings. A Registered Nurse with clinical and managed care experience is typically required for this position. (Source: eDOT Job Description) [-] Less
Cost of Living Data
A renter's cost of living for someone making $53,624 in Rockville, Connecticut is 112.2% of the US National Average. For more information, or to compare cost of living data between two cities, click here.
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