Immediate Opening Fresher - BSc Nursing

We are hiring!!!

Nursing Graduates for Utilization Management Specialist/Prior Authorization Specialist

Job Title: Utilization Management Specialist/Prior Authorization Specialist

Job 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 Skills

• Familiarity 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 :

Freshers with a Bachelor's Degree in Nursing are eligible to apply

Candidates already having work experience in Hospital Field is added advantage.

Willing to work in Night Shift.

Perks and Benefits

Five Days of working

Rotational Week off

Double Wages (If working on Saturday/Sunday)

Both 2 way Cab facility Available for only Night Shift.

Interested candidates can send their updated resumes to hr@shai.health.

(Mail subject line: Applying for UM - Fresher For any queries call or WhatsApp this

number: 78457 77499)

Thanks & Regards

HR Team