Utilization Specialist
Enterprise Engineering Inc. (EEI) · Florida, United States · 4 wk ago
On-siteOTHRContract
Location
Central Florida; must be willing to travel to Orlando or The Villages from time to time (remote, but available for onsite meetings).
Schedule
Part‑time, 20 hours per week, with the potential to transition to a full‑time opportunity.
Key Responsibilities
- Review any new Medicare patients from the last 3 months.
- For each new patient (whether seen or not):
- Review the patient’s HCCs.
- Review their ADTs.
- Check eCW/Prisma for documents available from hospitals.
- If the new patient has already been seen, also:
- Review charts and diagnostics.
- Review specialist visits and referrals that have been sent.
- Address other issues (smoking, alcohol, SDOH).
- Produce a member‑level report outlining KPIs.
Required Skills/Experience
- Moderate clinical background (required).
- Proficiency with MS Excel, Word, PowerPoint (required).
- Strong clinical background (preferred).
- Experience with eCW (preferred).