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)
Functioning within the Health System’s mission, values, objectives, and policies and procedures, the Medical Staff Peer Review Assistant is responsible for coordination of medical staff peer review committee functions including, but not limited to, compilation of statistics, agenda preparation, assignment of cases for physician review, preparation of meeting packet, take/type meeting minutes, referral letters and any meeting follow-up tasks. In addition, this position serves as department secretary for the Quality Resource Management Department.
Education: High School diploma or equivalent (GED) required. An associate’s degree in business/secretarial/administrative support is preferred.
Licensure/Certification: N/A
Experience: Minimum of one (1) year of experience in the clinical or healthcare business setting preferred. Experience with Word, Excel, and Outlook is preferred.
Skills: Excellent written and oral communication, listening and interpersonal skills, and basic competency with
Microsoft products (i.e. Word and Excel) preferred. Must also have the demonstrated ability to work
Independently and the ability to juggle competing demands and deal with interruptions.
0 Utilization Review Coordinator jobs found in Lima, OH area