Health Services - Utilization Management Specialist
Location
Baltimore, Maryland
Job Type
Full-time
Category
other-general
Posted
May 15, 2026
Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.
Job Title: Health Services - Utilization Management Specialist.
Location: Baltimore, MD.
Purpose:
Job Title: Health Services - Utilization Management Specialist.
Location: Baltimore, MD.
Purpose:
- Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage.
- Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mandates, medical policy, evidence-based published research, national accreditation and regulatory requirements contribute to determination of appropriateness and authorization of clinical services both medical an...