A highly organized and detail-oriented individual with a passion for monitoring adherence to the utilization review plans to ensure effective and efficient use of clinical services while overseeing the appropriateness of admissions and extended post-acute stays. Well-versed in performing frequent case reviews, checking medical records, speaking with patients/care providers regarding treatment, and responding to the plan of care. Proficient in monitoring charts and records to evaluate care concurrent with the patients treatment, reviewing treatment plans and status of approval from issuers, collecting and compiling data, and consulting with physicians when required. Clear communicator; possess robust conflict management, problem-solving, and interpersonal skills while responding to all requests appropriately, accurately, and timely according to the coordinated care department guidelines.