Discover your career path

Utilization Review Specialist

See to it that patients are receiving the proper treatments.

What does an Utilization Review Specialist do?

A Utilization Review Specialist is the quality assurance expert of the medical world. While patients focus on their recovery, Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.

As a Utilization Review Specialist, you can work in a clinic, a hospital, a Physical Therapist ‘s office – anywhere that provides long-term treatment to patients. You make sure each patient receives treatments tailored to their individual needs so they heal properly.

With the number of patients that your facility treats, the task of tracking all that information may sound overwhelming. Luckily, you have computers to help out. By reviewing patients’ charts, Doctor’s notes, and patient progress, you can determine whether or not the right treatment plan was chosen.

Particular areas of concern include medication and the length of the hospital stay or treatment program. Hospitals are always bustling with activity, and you see to it that each patient is fully ready to leave before being discharged. You also ensure that Nurses give accurate follow-up instructions to them.

As for medication, you want patients to receive only what they need. If a Doctor is assigning tons of pills for every minor condition, you need to talk to them about policies.

Finally, to ensure that the staff has the patients’ needs in mind, you may interview the patients or their families. You’ll quickly learn of any staff members who aren’t giving the job their all. Your watchful eye keeps patients on a happy, healthy road to recovery.