Utilization Review Coordinator jobs in El Cajon, CA

Overview

Paradise Valley Hospital is the South Bay’s oldest hospital, the second oldest hospital in all of San Diego County, and the largest employer in National City. For more than 100 years, Paradise Valley Hospital has served San Diego faithfully, proud of our heritage and providing numerous programs and services to meet the changing needs of our community. Our 291-bed, acute care hospital features the San Diego Spine & Joint Center, a highly credentialed acute rehabilitation center, our Paradise Health & Senior Center, a fully equipped and modern cardiac catheterization lab, and comprehensive inpatient and outpatient surgical services, and 24-hour emergency services.

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community!

Why Prime Healthcare? Paradise Valley Hospital; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. 

Paradise Valley Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs.

Our Total Rewards package includes, but is not limited to:

• Paid Time Off
• 401K Retirement Plan
• Outstanding Medical, Dental, Vision coverage
• Tuition Reimbursement
• Up to $20,000 Retention BONUS! *Restrictions Apply
• Many more voluntary benefit options!

In addition to our healthcare services, we offer comprehensive behavioral health services on the hospital campus and Bayview campus in Chula Vista. Services include psychiatric continuum of care for adult patients, inpatient services, and intensive outpatient services. Learn more at https://www.paradisevalleyhospital.net/.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Responsibilities

Responsible for the coordination of the various activities of the Case Management Department under the direction of the assigned Case Manager/Social Worker assist with development and implementations of discharge plans. Assists with case management referrals and authorizations. Maintains and coordinates Medicaid state submission forms for presentation to on-site reviewer and files them accordingly or as per facility's procedure. Assists with Discharge Planning as assigned by interviewing patients/families and gathering data to develop a safe patient-focused Discharge Plan.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications

1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non-managed care environments.2. Experience in basic to intermediate computer skills/knowledge.3. High School Diploma required.

Preferred qualifications:

1. Current BCLS certificate required upon hire and maintain current preferred.2. Associates degree or LVN license preferred.3. Experience in the hospital setting preferred.

Paradise Valley Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $18.00 to $26.18. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.