Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors patient charts and records to evaluate care concurrent with the patients treatment. Reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). Contributes to moderately complex aspects of a project. Work is generally independent and collab ...orative in nature. Typically requires 4 to 7 years of related experience.More Show Less
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As a. Utilization Review Coordinator. with Umpqua Health Alliance (UHA), you’ll be at the forefront of ensuring high-quality care by determining the medical necessity of requested services using Medicaid/Medicare criteria. In this remote position, you’ll combine clinical expertise, exceptional customer service, and a commitment to compliance to make a tangible impact on healthcare outcomes. Your Impact. Champion Accuracy. Maintain meticulous docu...
As a. Utilization Review Coordinator. with Umpqua Health Alliance (UHA), you’ll be at the forefront of ensuring high-quality care by determining the medical necessity of requested services using Medicaid/Medicare criteria. In this remote position, you’ll combine clinical expertise, exceptional customer service, and a commitment to compliance to make a tangible impact on healthcare outcomes. Your Impact. Champion Accuracy. Maintain meticulous docu...
Why work at Brighter Heights Arizona as a Utilization Review Coordinator. . Brighter Heights Arizona provides therapeutic services for adults with Severe Mental Illness (SMI), with homes in Northern Arizona, as well as child and adolescent therapeutic foster care homes throughout Arizona. Our services are licensed through the Arizona Department of Health Services and accredited through the Joint Commission. At Brighter Heights Arizona, our goal i...
Job Details. Level. Experienced. Job Location. Levittown, PA. Position Type. Full Time. Education Level. High School. Salary Range. Undisclosed. Job Category. Health Care. Description. Who We Are. STR Behavioral Health’s premier mental health and addiction treatment center located in Levittown. The programs we offer include detox, residential, partial hospitalization, intensive outpatient, and outpatient care with licensed recovery housing. The a...
Who We Are. STR Behavioral Healths premier mental health and addiction treatment center located in Levittown. The programs we offer include detox, residential, partial hospitalization, intensive outpatient, and outpatient care with licensed recovery housing. The approach at our treatment centers is firmly rooted in individualized, person-centered care to help clients uncover the why behind their disorders and help them build foundational relation...
OUR CULTURE. The minute you start working here, you become an integral part of our WE CARE Culture. Our mission is to provide a transformational influence for patients and their loved ones. Anchored in evidence-based practices, we facilitate person-centered accessible care. We provide best-in-class treatment for patients with a diagnosis of substance use disorder, mental health disorder or both. Our core values are represented in the acronym “WE ...
OUR CULTURE. The minute you start working here, you become an integral part of our WE CARE Culture. Our mission is to provide a transformational influence for patients and their loved ones. Anchored in evidence-based practices, we facilitate person-centered accessible care. We provide best-in-class treatment for patients with a diagnosis of substance use disorder, mental health disorder or both. Our core values are represented in the acronym “WE ...
Responsibilities. Are you passionate about maintaining the highest standards of patient care quality. We're seeking a dedicated Utilization Review Specialist (URS) to join our team and ensure that the services provided to our facility's residents are in full compliance with established quality standards. If you have a keen eye for detail, a strong understanding of medical records review, and a commitment to advocating for proper treatment, we wan...
Utilization Review Coordinator - Full Time - Days / Evenings. Cayuga Health and its affiliates are the region's leading healthcare system and most trusted providers of integrated health services, empowering our people in our mission to equitably improve the well-being of the communities we serve. Our commitment to providing extraordinary healthcare begins with our team of extraordinary professionals who are continuously discovering clinical innov...
New Vista Health and Wellness. is currently recruiting a. Utilization Review Coordinator. for our team in Blue Ash OH. WHO WE ARE. The New Vista mission. Inspiring Hope, Restoring Peace of Mind, Healing Lives. At New Vista, our passionate and highly trained team of professionals inspires hope and delivers holistic care to those in need of behavioral health services in a contemporary and healing environment – one that is conducive to providing the...
JOB DESCRIPTION. Job Summary. The primary goal is to monitor adherence to the facilitys utilization review plan to ensure the effective and efficient use of facility services and monitor the appropriateness of facility admissions and extended facility stays. Job Classification. Non Exempt Hourly. Reports To. . Senior RCM Director. Supervisory Responsibilities. None. JOB DUTIES. Completes Initial, concurrent, peer reviews, and expedited appeals in...
