Clinical Reviewer Utilization Management

University Health

San Antonio, Bexar County142032 - 142032📅 25/8/2026

Descripción

POSITION SUMMARY AND RESPONSIBILITIES Performs utilization management activities including prior authorization review, concurrent review, retrospective review, and appeal review activities utilizing approved medical necessity criteria, organizational policies, contractual requirements, and regulatory guidelines. Evaluates clinical information to determine medical necessity, appropriateness of care, level of care, and benefit coverage within delegated authority. Collaborates with providers, Medi…

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