Utilization Review Coordinator jobs in Fort Smith, AR

Utilization Review Coordinator 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. Being a Utilization Review Coordinator reviews treatment plans and status of approvals from insurers. Collects and complies data as required and according to applicable policies and regulations. Additionally, Utilization Review Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)

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Manager Clinical Review
  • AFMC
  • Fort Smith, AR FULL_TIME
  • Job Description:


    SCOPE OF POSITION:

    Responsible for managing specific areas of AFMC’s review services in accordance with contract deliverables. Responsible for the supervision assigned staff. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence Accountability, Respect and Teamwork.

    ESSENTIAL JOB FUNCTIONS:

    • Select, direct, coach and evaluate the assigned review staff. Develop standards of staff performance and set annual performance objectives. Ensure the quality and accuracy of work performed and that staff meet performance goals within designated time frame.
    • Supervise assigned review program/area/functions. Plan, schedule, direct and monitor review activities to comply with contract deliverables.
    • Develop and maintain manuals of policies, procedures, objectives and quality assurance for assigned review area.
    • Ensure review activities are documented through data system or manually and adequate controls are in place to assure validity of entry and results.
    • Function as a resource for clinical and non-clinical staff by providing oversight and follow-up for clinical related questions or issues.
    • Develop proposals and facilitate implementation of projects, procedures, and controls for current and anticipated contracts in cooperation with the Director, Clinical Review and Senior Director, Clinical Review.
    • Communicate effectively with internal and external clients. Upon request, verbally informs patients, facility personnel, the attending physician and other ordering providers, and health professionals of specific utilization management requirements and procedures
    • Serve as liaison between departments and vendors to provide information, project updates or in the resolution of administrative problems and inquiries.
    • Assume review activity during clinical review specialist absence or when assistance is needed. Work concurrently with clinical review specialist for evaluation and training purposes.
    • All clinical review managers will participate in the Quality Management Committee. Five percent of your time is allocated to the Quality Management Committee.
    • Analyze and control expenditures of department to conform to budgetary requirements.
    • Generate reports of projects activities as assigned or directed.
    • Maintain knowledge of specific projects including: contract, contract deliverables, policies and procedures, etc.
    • Assist in preparation, production, and delivery of educational activities for staff.
    • Adhere to format, content and style guidelines, giving consideration to usability and ensuring accuracy, consistency, and quality.
    • Meet regularly with assigned staff to communicate pertinent information, needs and requests to other team members as appropriate.
    • Train assigned staff on job specific regulations and contract requirements.
    • Ensure AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance.
    • Additional duties as assigned.

    KNOWLEDGE, SKILLS AND ABILITIES:

    • Intermediate skill level with MS Office (Word, Excel, Outlook, and PowerPoint).
    • Type 40 wpm.
    • Exceptional skills in business English and spelling required.
    • Ability to maintain confidentiality.
    • Coaching skills.
    • Strong oral and written communication skills.
    • Creativity.
    • Customer service.
    • Ability to delegate as required.
    • Ability to meet deadlines.
    • Attention to detail.
    • Flexibility.
    • Knowledge of ICD 9/ICD 10 Coding.
    • Knowledge of HIT/EHR.
    • Medical terminology.
    • Ability to work collaboratively and independently to achieve stated goals.
    • Initiative.
    • Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients and the public.
    • Leadership skills.
    • Ability to multitask.
    • Ability to prioritize.
    • Strong organizational skills.
    • Problem solving skills.
    • Professionalism.
    • Project management skills.
    • Ability to read, interpret and apply laws, rules and regulations.
    • Knowledge of quality improvement processes and techniques.
    • Valid driver’s license.
    • Ability to travel, including overnight travel.
    • Time management skills.




    Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
    Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to travel as needed. Must be capable of performing the essential job functions of this job, with or without reasonable accommodations.

    EDUCATION:
    Required: Associate or Bachelor’s degree in Health Information or Nursing ( ), licensed as a Registered Nurse in the state of Arkansas, without restrictions.
    Desirable: Master’s degree in nursing, health services administration, public health, business or related field



    EXPERIENCE:
    Required: Five (5) years clinical nursing experience, Three (3) years leadership experience.
    Desirable: Clinical experience in specialty area, experience in quality assurance, utilization review, coding, Medicare or Medicaid, QIO experience preferred.

    INTERNET REQUIREMENTS:
    Reliable, high-speed wireless internet service (Wi-Fi)
    An upload speed of at least 2Mbps is required to support softphone functionality.

  • 18 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • Cookson, OK FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • Just Posted

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Paid Product Tester
  • Product Review Jobs
  • Cove, AR FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • Just Posted

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Paid Product Tester
  • Product Review Jobs
  • GILLHAM, AR FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 25 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • NEW BLAINE, AR FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 25 Days Ago

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Paid Product Tester
  • Product Review Jobs
  • VANDERVOORT, AR FULL_TIME
  • Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
  • 25 Days Ago

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0 Utilization Review Coordinator jobs found in Fort Smith, AR area

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Construction Superintendent
  • Doyon Government Group
  • Fort Smith, MT
  • Job Description Job Description Doyon Technical Services (DTS) is a wholly owned subsidiary of Doyon Government Group (D...
  • 4/22/2024 12:00:00 AM

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Patient Serv Coord - NonClin
  • Amedisys
  • Van Buren, AR
  • Overview Are you a highly skilled and compassionate healthcare professional looking for a rewarding career in home healt...
  • 4/22/2024 12:00:00 AM

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Refrigeration Supervisor
  • Schwan's
  • Stilwell, OK
  • Schwans Company, a U.S. affiliate of the global lifestyle company, CJ CheilJedang Corporation, is a leading U.S. manufac...
  • 4/22/2024 12:00:00 AM

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Maintenance Planner
  • Koch Industries
  • Fort Smith, AR
  • Your Job Georgia-Pacific Dixie Consumer Products Operation is seeking qualified professionals to consider for a Maintena...
  • 4/21/2024 12:00:00 AM

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Cook
  • Oak View Group
  • Fort Smith, AR
  • Oak View Group: Oak View Group is the global leader in venue development, management, and premium hospitality services f...
  • 4/20/2024 12:00:00 AM

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RN Care Manager I-IP, FT
  • Hiring Now!
  • Moffett, OK
  • We're a Little Different Our mission is clear. We bring to life a healing ministry through our compassionate care and ex...
  • 4/20/2024 12:00:00 AM

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Clerical Specialist
  • Clermont County, OH
  • Fort Smith, AR
  • Would you like to work at a place that offers job stability, great benefits, and be a key member to a team that serves t...
  • 4/19/2024 12:00:00 AM

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County Meter Reader
  • Meter Reader
  • Fort Smith, AR
  • Responsibilities The primary responsibility of this position is to read meters and record consumption of the water used,...
  • 4/19/2024 12:00:00 AM

Fort Smith is the second-largest city in Arkansas and one of the two county seats of Sebastian County. As of the 2010 Census, the population was 86,209. With an estimated population of 88,037 in 2017, it is the principal city of the Fort Smith, Arkansas-Oklahoma Metropolitan Statistical Area, a region of 298,592 residents that encompasses the Arkansas counties of Crawford, Franklin, and Sebastian, and the Oklahoma counties of Le Flore and Sequoyah. Fort Smith has a sister city relationship with Cisterna, Italy, site of the World War II Battle of Cisterna, fought by United States Army Rangers c...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$70,387 to $87,191
Fort Smith, Arkansas area prices
were up 1.2% from a year ago

Utilization Review Coordinator in Fort Lauderdale, FL
Some review coordinator positions require that professionals have training and experience within a more specific field.
January 10, 2020
Utilization Review Coordinator in Asheville, NC
Schick Shadel Hospital is seeking a part-time (20 hours per week) Utilization Review Coordinator (UR Coordinator) to help oversee and perform the process of utilization review to ensure appropriate reimbursement by third party payers.
January 04, 2020
Utilization Review Coordinator in Jacksonville, FL
Excellent benefits, pay, small on-site employee gym, wonderful co-workers and managersFull Review.
January 04, 2020