Utilization Mgmt Support Specialist II

Utilization Mgmt Support Specialist II at Sutter Health will accumulate, process, and interpret payer information to justify acute hospital admission, continued stay, and appropriate level of care for billing. Responsible for processing concurrent and retrospective denials in collaboration with clinical utilization management staff and physician advisors, and for developing, coordinating, and monitoring systems for the appeal/denial process. The role tracks trends data, coordinates utilization management operations with leadership and stakeholders, and acts as a liaison between leadership, external payers, staff, and related services. Maintains compliance with local/state/federal regulations and privacy/safety standards while delivering patient care. Responsibilities also include assisting with projects, participating in department meetings, and contributing to process improvements. Must communicate effectively with team members, supervisors, patients, and other personnel; demonstrate strong time management and organizational skills; and be proficient with electronic health records and computer applications. Job shift: days; schedule: full-time; weekends: rotating; benefits included; EOE/M/F/Disability/Veterans.