Utilization Review Coordinator jobs in Pittsburgh, PA

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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DA CM Utilization Review-Continuing Care Coordinator
  • SPHS GROUP
  • Greensburg, PA OTHER
  • Job Details

    Job Location:    Southwest Behavioral Care D&A Case Management - Greensburg, PA
    Position Type:    Full Time
    Salary Range:    Undisclosed

    Description

                                                                                                                           

    SOUTHWEST BEHAVIORAL CARE, INC.

    POSITION : D&A Case Management Utilization Review/Continuing Care Coordinator

    Full-Time Position -Greensburg, PA Location

    Work alongside our HEROES… APPLY TODAY AND BECOME A PART OF THE SPHS FAMILY!

    **COMPREHENSIVE BENEFIT PACKAGE (FOR ELIGIBLE EMPLOYEES) INCLUDING MEDICAL AND DENTAL**

    **OPPORTUNITY FOR PROFESSIONAL GROWTH AND ADVANCEMENT**

    **TUITION DISCOUNTS WITH PARTICIPATING COLLEGES AND UNIVERSITIES**

    Responsible for the Utilization Reviews for clients and services and outcome/tracking for the Single County Authority and other funding sources.

    ESSENTIAL FUNCTIONS:

    • Maintains current client case record activity and progress; prepares and assists in tracking all data needed for required program reports and documentation as required by WeDAC, licensing, any funder and DDAP in an accurate and timely manner.
    • Monitors and trouble shoots linkage with medical assistance and continuation of medical assistance through all levels of treatment and recovery support care, for both incarcerated individuals targeted through the Jail, MAT Programs, general community, and hospital-based clients.
    • Monitors electronic health records for compliance of licensing and DDAP requirements. 
    • As needed, assists in contacting clients waiting for detoxification beds and assesses their emergent care needs until withdrawal management can occur.
    • As needed, conducts initial client assessments, and facilitates referral and placement to the indicated level of care.
    • Identifies appropriate treatment care providers, as well as necessary support services, and serves as the link to same.
    • Participates in all appropriate staff meetings and maintains beneficial dialogue with all members of the Case Management team and treatment providers, as necessary, regarding clients.
    • Becomes a Narcan Trainer and conducts community Narcan trainings as needed.
    • Participates in community coalitions and public relations events as needed.
    • Adheres to all policies, laws, regulations and codes of ethics and confidentiality as outlined by federal and state laws, and agency policies and procedures.

     

     

     

     

     

    Qualifications


     

    • Bachelor’s Degree in social work, Psychology or related human services field from an accredited college or university.
    • Demonstrated ability to obtain vital information during an interview to make proper recommendations.
    • Demonstrated knowledge of financial entitlement programs and available social services.
    • Must not be excluded from participation in Medicare, Medicaid, or any other federal health care program.
    • Must successfully obtain Criminal History Clearance from the Pennsylvania State Police, Child Abuse and FBI Clearances from the Pennsylvania Department of Human Services.
    • Willing to obtain the Certified Allied Addiction Practitioner certification.
    • Must have 3 years applicable direct service experience.
    • Ability to transport oneself in an insured vehicle, as program needs dictate.
    • Ability to observe and recognize verbal and non-verbal signs of physical or mental disorders.
    • Ability to detect and identify violations pertaining to program regulations.

      QUALIFIED INDIVIDUALS SHOULD VISIT OUR WEBSITE FOR CURRENT EMPLOYMENT OPPORTUNITIES.

                                                                                   EQUAL OPPORTUNITY EMPLOYER

     

     

     

     

     

     

  • 6 Days Ago

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DA CM Utilization Review-Continuing Care Coordinator
  • SOUTHWEST BEHAVIORAL CARE INC
  • Greensburg, PA FULL_TIME
  • SOUTHWEST BEHAVIORAL CARE, INC. POSITION : D&A Case Management Utilization Review/Continuing Care Coordinator Full-Time Position -Greensburg, PA Location Work alongside our HEROES… APPLY TODAY AND BEC...
  • 7 Days Ago

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Salon Coordinator
  • Sport Clips - Coordinator - PA102
  • Pittsburgh, PA FULL_TIME
  • Sport Clips is seeking a dynamic and enthusiastic Salon Coordinator to join our team and play a pivotal role in delivering exceptional customer service and ensuring the smooth operation of our salon. ...
  • 20 Days Ago

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Document Review Attorney - Remote
  • Dauntless Discovery
  • Pittsburgh, PA FULL_TIME
  • Experienced Document Review Attorney – RemoteGreat opportunity for licensed attorneys with document review experience interested in quality focused e-Discovery. We have some projects anticipated to st...
  • 8 Days Ago

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Senior Program Operations Manager Specialist, Aerospace Electrification
  • Performance Review Institute (PRI)
  • Warrendale, PA FULL_TIME
  • DescriptionAre you ready to step into the future? SAE Industry Technologies Consortia (SAE ITC) is seeking a Senior Program Operations Manager Specialist with a passion for driving industry consensus ...
  • 21 Days Ago

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Registrar Scheduler
  • Performance Review Institute (PRI)
  • Warrendale, PA FULL_TIME
  • DescriptionJOB SUMMARY The position is responsible for working with the Lead Scheduler to effectively schedule all client audits, new and existing, both nationally and internationally. This process re...
  • 24 Days Ago

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0 Utilization Review Coordinator jobs found in Pittsburgh, PA area

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Senior Specimen Processor/Specimen Processor, Daylight
  • Upmc - Pittsburgh Medical Center
  • Pittsburgh, PA
  • Job Description Are you someone with customer service, retail distribution, or similar experience looking to get into th...
  • 3/28/2024 12:00:00 AM

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Medical Receptionist
  • Alliance Physical Therapy & Rehabilitation Services
  • Penn Hills, PA
  • Job Description Job Description Job Responsibilities: Medical Secretary/Front Desk Coordinator Serves patients by greeti...
  • 3/28/2024 12:00:00 AM

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SBA Credit Administration and Tickler Management Team Lead
  • Innovative Financing Solutions
  • Pittsburgh, PA
  • Job Description Job Description GENERAL PURPOSE OF JOB Independently the incumbent is responsible for leading the team r...
  • 3/27/2024 12:00:00 AM

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Meat Processing Team Member
  • Giant Eagle
  • Freedom, PA
  • Job Summary Full Time Meat Processing Team Members at FFM enjoy: • $16.00/hour • $1000 New Hire Bonus • Weekly pay • 4-d...
  • 3/27/2024 12:00:00 AM

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Firearms Associate
  • Rural King
  • Washington, PA
  • About us Rural King Farm and Home Store strives to create a positive and rewarding workplace for our associates. We offe...
  • 3/27/2024 12:00:00 AM

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Chief Administrative Officer
  • AIMED HUMAN SERVICES
  • Pittsburgh, PA
  • Title: Chief Administrative Officer Responsible to: President/CEO General Description of Duties and Responsibilities: We...
  • 3/26/2024 12:00:00 AM

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Drafter Associate
  • Curtiss Wright EMD
  • Cheswick, PA
  • We are looking for a Drafter Associate to join our Pittsburgh (Cheswick) location. Your Responsibilities: You will prepa...
  • 3/26/2024 12:00:00 AM

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Construction Supervisor
  • Empyrean
  • Mount Pleasant, PA
  • Construction Supervisor Location: (Onsite) Mount Pleasant, PA Duration: 9 Months Work Hours: 40 hours a week 8 hours a d...
  • 3/24/2024 12:00:00 AM

Pittsburgh (/ˈpɪtsbɜːrɡ/ PITS-burg) is a city in the Commonwealth of Pennsylvania in the United States, and is the county seat of Allegheny County. As of 2018, a population of 308,144 lives within the city limits, making it the 63rd-largest city in the U.S. The metropolitan population of 2,362,453, is the largest in both the Ohio Valley and Appalachia, the second-largest in Pennsylvania (behind Philadelphia), and the 26th-largest in the U.S. Pittsburgh is located in the south west of the state, at the confluence of the Allegheny, Monongahela, and Ohio rivers. Pittsburgh is known both as "the ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$79,460 to $98,423
Pittsburgh, Pennsylvania area prices
were up 1.9% 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