4 UTILIZATION REVIEW SPECIALIST Jobs in Fresno, CA
County of Fresno is Hiring an UTILIZATION REVIEW SPECIALIST Near Fresno, CA
Step 6 effective 7/8/24 ($97,110 - $123,942 Annually)
3% effective 1/20/25 ($100,022 - $127,660 Annually) APPLICATIONS MUST BE SUBMITTED ONLINE ONLY The Fresno County Department of Behavioral Health invites applications for the position of Utilization Review Specialist. Incumbents review client health records to ensure proper utilization of treatment resources. Responsibilities include reviewing provider's admission data and clinical documentation to ensure compliance with federal, state, and county regulations relating to medical necessity, and proper case documentation, as well as performing a variety of assignments within quality assurance and/or substance use disorder programs.
Fresno County is a richly diverse community, and in order to support and serve ALL persons in our community, the Fresno County Department of Behavioral Health is dedicated to ensuring an inclusive overall system of care through a commitment to equity, diversity, and affirming care. We are dedicated to providing quality, culturally responsive services that promote wellness, recovery, and resilience for individuals and families whom we serve.
It is imperative for us to protect and improve the lives of Fresno County residents served by the Department and our partners in our system of care by acknowledging the long-standing historic and ongoing inequities that black, indigenous and people of color, those living in poverty, LGBTQ members and other marginalized and underserved communities have experienced with the behavioral health system.
We place a great deal of importance on having Behavioral Health system of care team members who possess lived experience, are reflective of our community, and have the expertise to ensure our workforce is culturally and linguistically responsive and maximizes our diversity to render quality services in the most responsive, affirming, and caring manner possible for the persons we serve.
Note: The eligible list established from this recruitment may be used to fill both extra-help and permanently allocated positions. Individuals selected for extra-help appointment may be transitioned to a permanently allocated position at a later date as authorized by the Fresno County Personnel Rules.
Positions in this classification are in Medical Group I - Light Physical Activity. This group includes positions which require only light physical effort and may include lifting of small, light objects and some bending, stooping, squatting, twisting, and reaching. Considerable walking or standing may be involved.
Eligible candidates must be able to perform the essential functions of the position with or without reasonable accommodation.
Samples of DutiesPlease click here to review the Samples of Duties.
Knowledge, Skills And AbilitiesPlease click here to view Knowledge, Skills, and Abilities .
Minimum QualificationsExperience : Two (2) years of full-time, paid, post-licensure work experience providing direct behavioral health care services as a licensed Registered Nurse.
Licenses: Valid State of California license as a Registered Nurse.
Possession of a valid Class "C" driver's license, or equivalent.
Must pass initial credentialing and re-credentialing requirements. Must remain compliant at all times with state licensing credentialing requirements while occupying this classification. All providers in this classification are required to have a valid National Provider Identifier (NPI) number prior to their first day of employment and maintain a valid NPI throughout the duration of their tenure in this classification. In addition, all providers in this classification must be registered with the National Plan and Provider Enumeration System (NPPES) under the correct taxonomy.
To Prevent The Disqualification Of Your Application, Please Note
- Applicants must meet the minimum qualifications and filing requirements for this position by the filing deadline.
- A completed Fresno County employment application is required and must be current, complete and accurate. Amendments will not be allowed after the filing deadline.
- Resumes and attachments are not accepted in lieu of a completed application.
- Please fully list your work experience, including current position. Failure to list current, complete and accurate work experience within the job application (including employment with the County of Fresno) will result in the disqualification of your application.
- This position requires possession of a valid California license as a Registered Nurse. Please provide your applicable license number on your application. Failure to list this information will result in the disqualification of your application.
- The minimum qualifications for this recruitment have been limited to candidates with an experience background related to the specific position vacancy.
- Oral Examination - If required, the examination may be offered in an online format. Please indicate on the supplemental questionnaire if you have the ability to complete an online examination.
- Certify without Examination - In instances where the number of eligible candidates is less than or equal to the number of qualified applicants the Department is entitled to receive under Personnel Rule 4212, the competitive examination process will be waived and the names will be certified without an examination.
Required Application Materials
- Fresno County Employment Application
- Supplemental Questionnaire.
How To ApplyApplications for this recruitment must be submitted online only. Online applications may be found at FresnoCountyJobs.com .
Open the job information flyer and click "Apply" to begin the online application process. Failure to complete the job application or failure to follow the application instructions may result in the disqualification of the applicant. Amendments will not be accepted after the filing deadline.
Once the filing date has passed you may check the status of this recruitment at any time by logging on to https://www.governmentjobs.com/Applications/Index/fresnoca .
Please be advised that it is the applicant's responsibility to notify Human Resources of any mailing address and telephone number changes. Notices sent via U.S. mail from Human Resources are not forwarded ("Return Service" is requested, therefore, mail will not be sent to a forwarding address).
For the safety of our employees, the County of Fresno complies with all Federal, State and Local Orders related to COVID-19, including Cal OSHA Emergency Temporary Standards.
The County of Fresno is an Equal Employment Opportunity Employer. It is the policy of Fresno County to provide employment opportunity for all qualified persons. All applicants will be considered without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition, genetic information, or denial of medical and family care leave, or any other non-job-related factor.
REASONABLE ACCOMMODATIONS - The County of Fresno is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and the Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application, examination or selection process may contact Human Resources at (559) 600-1830 at least five days prior to the scheduled date or deadline .
EQUAL EMPLOYMENT OPPORTUNITY EMPLOYER Analyst: Tiffany Lee
Job Summary
Temporary
Consumer Services
$58k-81k (estimate)
05/23/2023
07/03/2024
co.fresno.ca.us
KINGSBURG, CA
500 - 1,000
Private
CARMEN ROJAS
$1B - $3B
Consumer Services
Related Companies
The job skills required for UTILIZATION REVIEW SPECIALIST include Clinical Documentation, Quality Assurance, etc. Having related job skills and expertise will give you an advantage when applying to be an UTILIZATION REVIEW SPECIALIST. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by UTILIZATION REVIEW SPECIALIST. Select any job title you are interested in and start to search job requirements.
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Quotes from people on Utilization Review Specialist job description and responsibilities
Utilization Review Specialists ensure that Doctors and Nurses choose only the best treatments for them.
03/11/2022: Fort Myers, FL
Utilization review typically refers to the review of services that have already been delivered, while utilization management often refers to the review of coverage for future medical services.
02/16/2022: Louisville, KY
Assess plans for patient care and determine what treatment is appropriate and most cost-effective
02/15/2022: Augusta, GA
Analyze electronic medical records, and inform medical staff whether a medical claim is denied,
03/11/2022: Boston, MA
Prepares and submits regular reports on utilization control and on review activities.
02/26/2022: Reading, PA
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Career tips from people on Utilization Review Specialist jobs
Know where to find utilization review jobs.
03/13/2022: Clarksville, TN
Create a utilization review cover letter.
02/18/2022: Reno, NV
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03/16/2022: New London, CT
Set up documentation shortcuts.
03/05/2022: Lawton, OK
Take the certification examination.
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Step 3: View the best colleges and universities for Utilization Review Specialist.
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