Utilization Specialist

Part time 20 hours a week then will go to a Full Time Opportunity Location : Central Florida; must be willing to travel to Orlando or Villages from time to time (remote, but available for onsite meetings)

Key Responsibilities : Review any new Medicare patients from last 3 months

• Whether new patient is seen or not, this person would:

• Review each new patient's HCCs

• Review their ADTs

• Review eCW/Prisma for documents available from hospitals

• If new patient is already seen, this person will also do the following:

• Review charts and diagnostics

• Specialist visits and referrals we've sent

• Other issues (Smoking, alcohol, SDOH)

• Produces a member-level report outlining KPIs

• Required Skills/Experience:

• Required

• Moderate clinical background

• MS Excel, Word, PowerPoint

• Preferrable

• Strong clinical background

• eCW experience