| JOB TITLE: Utilization Management Specialist LOCATION: Geisinger Centerpoint DEPARTMENT: Geisinger Health Plan Medical Management WORK SCHEDULE: Days/Evenings WORK TYPE: Full Time HIRING MANAGER: Erin E. Griffith JOB SUMMARY: Assesses and manages admitted members or patients. Assures delivery of comprehensive, cost-effective, quality care, as well as appropriate allocation of medical resources. Assesses, plans, implements, coordinates, monitors and evaluates all options and services to assure safe transitions of care that will support best outcomes for patients and their families. Assesses for accuracy in the assignment of patient status to reflect congruence with clinical condition, physical intent and utilization review outcomes. COMPETENCIES AND SKILLS: Demonstrates strong clinical assessment skills and excellent communication, organization and time management skills. Demonstrates customer focused interpersonal skills to interact in an effective manner. Demonstrates the ability to function independently and effectively in a rapidly changing environment, as well as the ability to influence and negotiate individual and group decision-making processes. Demonstrates general computer knowledge, with proven keyboarding proficiency. EDUCATION AND/OR EXPERIENCE: Required Experience: 3 years related experience. EDUCATION Master's Degree in Social Work (MSW) or Psychology (MS) from accredited school or program required. Preferred Education: CERTIFICATIONS/LICENSURES LSW (Licensed Social Worker) LCSW (Licensed Clinical Social Worker), or LPC (Licensed Professional Counselor) with the Pennsylvania State Board preferred. Licensure required within 1 year of hire. Valid Driver’s License required. WORKING CONDITIONS/PHYSICAL DEMANDS: Work is typically performed in an office setting or clinical setting. Travel may be required. On-call coverage is part of this role The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation. ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family. We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter. ** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status. *Domestic partner benefits not applicable at Geisinger Holy Spirit. | 
