Utilization Review Coordinator jobs in Omaha, NE

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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Admissions Coordinator / Utilization Review
  • Stephen Center
  • Omaha, NE FULL_TIME
  • Stephen Center has served homeless and low-income individuals in Omaha since 1984 with the mission to partner with the community, families and individuals to overcome homelessness, addiction and poverty. The Pettigrew Emergency Shelter and Permanent Supportive Housing offerings provide safe and secure housing while individuals and families complete an assessment of permanent housing options. All Stephen Center residents have access to dual diagnosis support services via the HERO addiction/recovery program. 100% of Stephen Center shelter supportive housing participants are living in poverty. Housing transition support identifies poverty barriers that may impact one’s ability to achieve or maintain permanent housing through case management, life skills, and behavioral health services. Stephen Center serves approximately 250 people daily in all programs.

    Purpose: The primary purpose of the admissions Coordinator is to connect existing and potential clients to valuable Stephen Center mental health and substance abuse services, while creating and maintaining an atmosphere of warmth, personal interest and positive emphasis.



    Key Accountabilities:

    • Maintains comprehensive working knowledge of markets including government agencies, major payer groups, and key referral sources.
    • Responsible for developing and maintaining a positive relationship with referral sources as well as designated communities, and for providing education on topics pertaining to Stephen Center services.
    • Manages and accepts referrals. Initiates appropriate communication with clinical and operations teams based on the needs of referred clients/individuals to facilitate appropriate placement and/or services.
    • Maintain contact/waiting lists and follow up with potential clients to continue relationships; Uses active phone advocacy, this includes cold call follow-ups to the referral sources and regular email contacts.
    • Performs regular follow-up on results of evaluations, proactively promoting services and recruiting and providing support to potential clients, their families, referrals, and payers seeking services.
    • Collects, verifies, records and processes client demographics, insurance /payment and referral information.
    • Inputs data and completes all placement paperwork. Identifies problems and resolves issues preventing successful documentation/entry.
    • Create files for new individuals and ensure intake paperwork has been completed/requested.
    • Secure funding information, verify funding/insurance coverage arrangements, and obtain insurance pre-authorization for placement and services.
    o Obtain clinical information from therapist to obtain treatment coverage from MCO
    o Consult with therapist to review clients level of care
    o Consults with clinical team for medication management
    o Consults with clinical team for clients progress/transition/Aftercare plan
    • Complete all reporting requirements consistent with corporate and regulatory standards.
    • Apply knowledge and understanding of programs, policies, procedures, and information to serve as a resource to clients and referral sources and to assist others in resolving administrative issues within scope of authority.
    • Run statistical reports for the HERO program for intakes, occupancy and client exits
    • Additional responsibilities may be assigned.

    Position Requirements:

    • Formal training in business or office management, or commensurate work experience in a business setting.
    • Credit or non-credit courses in computer fundamentals and the application of basic office management software in the business setting.
    • Strong work experience in an administrative position.
    • Self-starter/manager.
    • Team player with ability to job share.
    • Excellent written, oral and interpersonal communication skills.
    • Proficiency with PC applications to include Microsoft Word, Microsoft Excel and Access.
    • Strong organizational and time management skills.
    • Ability to manage and coordinate multiple tasks and balance long and short-term projects simultaneously.
    • Ability to manage and work with volunteers.
    • Ability to work with staff quickly, accurately and effectively in a dynamic work environment.
    • Commitment to the utmost confidentiality in the handling of all client activities, client records, files, etc.
    • Conducts self in a manner of professionalism that is conducive to recovery from mental illness, co-occurring disorders and overall wellness, including a minimum of one year of continuous sobriety if in recovery, from the substance for which you are in recovery. Abides by all specific program and Agency procedures, policies, and requirements.
    • Work environment characteristics describes here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
    • While performing the duties of this job, the employee is not exposed to weather conditions. The noise level in the work environment is usually moderate.
    • Ability to two way verbally communicate.
    • Sitting-Periodically.
    • Standing/Walking-Periodically.
    • Kneeling-Periodically.
    • Pushing/Pulling-Periodically.
    • Lifting up to 25 pounds-Periodically.

    PLADC/LADC, BA/BS preferred; relevant experience in lieu of the degree/license will be considered.

    BA/BS in Social Work, Psychology, Family Science.




    Great health benefits:

    Medical

    Dental and vision are covered 100%

    Pay: $20/hour

    Other Benefits include:

    SIMPLE IRA with 3% match

    Paid PTO

    Complimentary Life Insurance, Accidental Death/Dismemberment Insurance

    10 paid holidays

    Free Planet Fitness membership to 36th & L location-$120 value!

    22% Discount at Verizon Wireless

    Free on-site lunches

    Monthly employee engagement activities, recognition opportunities and more!!

    Stephen Center offers competitive salaries and a full array of benefits commensurate with NAM Guidelines.

    Stephen Center is an Equal Opportunity Employer.

    Thank you for your interest in Stephen Center!

  • 1 Month Ago

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Utilization Review RN Case Manager
  • SHELBY COUNTY CHRIS A MYRTUE MEMORIAL HOSPITAL
  • Harlan, IA FULL_TIME
  • SCHEDULE: Full-time; 36 hours per week; 9-hour shifts; Monday - Friday The RN Case Manager is responsible for coordinating each patient's hospitalization from preadmission through discharge by assessi...
  • 1 Day Ago

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Utilization Review RN Case Manager
  • Myrtue Medical Center
  • Harlan, IA FULL_TIME
  • SCHEDULE: Full-time; 36 hours per week; 9-hour shifts; Monday - Friday The RN Case Manager is responsible for coordinating each patient's hospitalization from preadmission through discharge by assessi...
  • 1 Day Ago

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Utilization Review Assistant (Workers Compensation)
  • Berkshire Hathaway Homestate Companies
  • Omaha, NE OTHER
  • WHAT WE'RE LOOKING FORThe Utilization Review Assistant ensures the timely and accurate collection of data and documents necessary for the utilization review process as well as independent medical revi...
  • 15 Days Ago

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Care Transitions/Utilization Review Registered Nurse
  • Crawford County Memorial Hospital
  • Denison, IA FULL_TIME
  • Essential Duties and Responsibilities: Interview patient and family members to obtain information about home environment, family relationships, health history, and patients personality traits. Assist ...
  • 4 Days Ago

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Utilization Management Assistant
  • CHI Health Immanuel
  • OMAHA, NE PART_TIME
  • OverviewOur Utilization Management Assistant receives, processes, facilitates and documents all payer communications. This position supports denial mitigation by sending documentation within the contr...
  • 29 Days Ago

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0 Utilization Review Coordinator jobs found in Omaha, NE area

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SECRETARY - Parks Department
  • City of Bellevue
  • Bellevue, NE
  • If you have the needed qualifications, please complete an application @ www.bellevue.net . This position will be posted ...
  • 4/26/2024 12:00:00 AM

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Grant Administrative Assistant
  • Boys Town
  • Omaha, NE
  • Provides administrative assistance for managing day-to-day aspects of grant processing and reporting and will also provi...
  • 4/26/2024 12:00:00 AM

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OFFICE CLERK
  • ABM Industries, Inc.
  • Omaha, NE
  • Job Description The Dispatcher receives assistance requests from clients and customers, and assigns individuals and team...
  • 4/26/2024 12:00:00 AM

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Supervisory Tax Specialist (TCO Group Manager), NTE 1 YR (12 MONTH ROSTER) (Amended)
  • Department Of The Treasury
  • Omaha, NE
  • Duties WHAT IS THE TAX EXEMPT/GOVERNMENT ENTITIES (TEGE) DIVISION? A description of the business units can be found at: ...
  • 4/26/2024 12:00:00 AM

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Internal Revenue Agent (Tax Exempt Bonds Agent - Examiner) 12 MONTH ROSTER AMENDED
  • Department Of The Treasury
  • Omaha, NE
  • Duties WHAT IS THE TAX EXEMPT AND GOVERNMENT ENTITIES (TE/GE) DIVISION? A description of the business units can be found...
  • 4/25/2024 12:00:00 AM

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Underground Construction Superintendent
  • Dycom Industries Inc
  • Omaha, NE
  • Overview and Essential Functions This position will oversee productivity and quality of work on daily operations and pro...
  • 4/25/2024 12:00:00 AM

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Credentialing Coordinator
  • Commonspirit Health
  • Omaha, NE
  • OverviewREMOTE WORK OPPORTUNITY - T his position can work in Omaha or Kearney or RemoteYour time at work should be fulfi...
  • 4/24/2024 12:00:00 AM

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Linen Processor - Full Time - Days
  • Methodist Health System
  • Omaha, NE
  • Why work for Nebraska Methodist Health System? At Nebraska Methodist Health System, we focus on providing exceptional ca...
  • 4/22/2024 12:00:00 AM

Omaha (/ˈoʊməhɑː/ OH-mə-hah) is the largest city in the state of Nebraska and the county seat of Douglas County. Omaha is located in the Midwestern United States on the Missouri River, about 10 miles (15 km) north of the mouth of the Platte River. The nation's 40th-largest city, Omaha's 2018 estimated population was 466,061. Omaha is the anchor of the eight-county, bi-state Omaha-Council Bluffs metropolitan area. The Omaha Metropolitan Area is the 59th largest in the United States, with an estimated population of 944,316 (2018). The Omaha-Council Bluffs-Fremont, NE-IA Combined Statistical Are...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$76,676 to $94,981
Omaha, Nebraska area prices
were up 0.8% 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