Utilization Review Coordinator jobs in Antioch, CA

The Position

Bargaining Unit: Local 21 – Non-Supervisory Management
CLOSING DATE: May 10, 2024.

• Has strong analytical skills which include prospective, concurrent, and retrospective reviews that use evidence-based guidelines.
• Is strong in communication with the physician reviewer, attending physicians, and other healthcare professionals, as well as reporting important utilization review trends and problems.
• Is an innovative problem-solver during discharge assessments at the time of admission and discharge needs.
• Is proactive and a self-starter with the ability to also work collaboratively as part of a team.
• Maintains a calm demeanor, exercises compassion, and manages stress effectively.

• Determining if the conditions of patients and clinical findings meet the acute hospital criteria.
• Determining if patients cooperate with the required acute level of services and care, as well as monitoring for timeliness and appropriateness of the delivery for quality and safety of care.
• Assessing discharge planning needs and reporting cases that require physician review for inappropriate utilization of resources and/or questionable quality of care.
• Supporting Medical Staff peer review that includes case identification and meeting support.
• Ensuring regulatory compliance and continuous survey readiness.
• Designing and performing audits, observations, rounds, and tracers to evaluate regulatory compliance and quality of care, as well as identify opportunities for improvement.
• Serving as a resource to others in the organization on regulations and performance improvement.

• You have the opportunity to impact the lives of a vulnerable patient population.
• This is a dynamic organization with a highly dedicated and diverse team of professionals who value the service of others.
• The organization prioritizes quality improvement, creativity, and life-long learning.
• You will have job stability and opportunities for career growth.
• The County offers fantastic and competitive health benefits, paid vacation/sick/personal leave, and a great retirement plan! Check them out here: Employee Benefits | Contra Costa County, CA Official Website
• You will be a member of a strong Union that supports its members! Here’s Local 21’s Memorandum of Understanding (MOU) LOCAL-21-MOU-FOR-2022-2026
• Do you have student loans? Public Service Loan Forgiveness (PSLF) is the most common way people apply to have their student loans forgiven. The County is a qualified employer!

• You will work in a fast-paced environment that provides support for team members who provide direct services to populations that have complex needs.
• You will encounter days where you must balance your own workload and provide support to team members.
• You must quickly change the prioritization of work as short or long-term projects arise with strict deadlines.

• Analyzing & Interpreting Data: Drawing meaning and conclusions from quantitative or qualitative data
• Fact Finding: Obtaining facts and data pertaining to an issue or question
• Legal & Regulatory Navigation: Understanding, interpreting, and ensuring compliance with laws and regulations
• Safety Focus: Showing vigilance and care in identifying and addressing health risks and safety hazards
• Attention to Detail: Focusing on the details of work content, work steps, and final work products
• Self-Management: Showing personal organization, self-discipline, and dependability
• Writing: Communicating effectively in writing
• Involving Others (Engaging Teams): Engaging others for input, contribution, and shared responsibility for outcomes
• Group Facilitation: Enabling constructive and productive group interaction
• Managing & Facilitating Change: Addressing key factors that influence successful organizational change
• Leveraging Technology: Applying technology for improvements in organizational efficiency and effectiveness
• Project Management: Ensuring that projects are on-time, on-budget, and achieve their objectives
• Strategic Thinking & Perspective: Evaluating immediate actions in context of achieving long range objective

Minimum Qualifications

• Training or experience in Quality Improvement methodologies
• Ability to analyze data
• Computer literacy with advanced skills in Excel and EPIC
• Organized succinct writing and presentation skills
• Ability to prioritize and manage multiple projects
• In-depth knowledge of regulations impacting healthcare organizations

Selection Process

1. Application Filing and Evaluation: All applicants will be required to complete a supplemental questionnaire at the time of application. Applications will be evaluated to determine which candidates will move forward in the next phase of the recruitment process.

2. Training and Experience Evaluation: At the time of filing, within the supplemental questionnaire, candidates will be required to complete a training and experience questionnaire. Candidates who clearly meet the minimum qualifications, as described above, will have their training and experience responses evaluated, which will determine their score and rank on the eligible list. The training and experience questionnaire is designed to measure the candidate’s relevant education, training, and/or experience as it relates to the position. (Weighted 100%).

3. Final Selection Interviews: The hiring manager interviews will be scheduled directly by the unit/division once the eligible list is established.