Utilization Review Coordinator jobs in Salisbury, NC

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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Utilization Manager
  • Gentiva
  • Mooresville, NC FULL_TIME
  • Our Company

     

    Gentiva is an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support to patients and their families so they may make the most of every moment. We believe that better care for caregivers and clinicians means better care for everyone, so we offer ongoing professional training, lower nurse-to-patient ratios, and comprehensive benefits for eligible employees. Here, you’ll join gifted colleagues who make a lasting difference in people’s lives every day.

     

     

     

     

     

     

     

     

     

     

     

     

    Overview

    The Utilization Manager plans, coordinates, implements, and finalizes projects according to the specifications, deadlines, and budget.  The role manages the daily, weekly, and monthly metrics, processes, and reporting for medical supplies, durable medical equipment, and pharmacy utilization.  This role also works closely with branch personnel to identify and deploy best practice utilization processes.  This role will work with PPO vendors to ensure service levels are at or above expectations and when less deploy corrective action plans for improvement in conjunction with the vendor. The individual must be able to travel 50% of the time.

    About You

    • Experienced in hospice branch leadership and management
    • Knowledge of hospice rules, regulations, and Conditions of Participation
    • Proven analytic skills, including mining, evaluation, analysis, and visualization
    • Demonstrated experience in leading and managing complex projects that are strategic in nature and national in scope
    • Bachelors Degree
    • 3 years experience mining data as a data analyst or related experience
    • PMP preferred
    • RN Preferred
    • At least 2 years of experience planning, leading, and directing complex initiatives

    • Healthcare/Clinical Experience preferred

    • At least 5 years of experience planning, leading, and directing complex initiatives

    • Healthcare/Clinical Experience preferred

    We Offer

    • Comprehensive Benefits Package: Health Insurance, 401k Plan, Tuition Reimbursement, PTO
    • Opportunity to Participate In a Fleet Program
    • Competitive Salaries
    • Mileage Reimbursement
    • Professional Growth and Development Opportunities

    Legalese

    • This is a safety-sensitive position
    • Employee must meet minimum requirements to be eligible for benefits
    • Where applicable, employee must meet state specific requirements
    • We are proud to be an EEO employer
    • We maintain a drug-free workplace
  • 24 Days Ago

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Utilization Manager - Remote
  • Gentiva
  • Mooresville, NC FULL_TIME
  • Our Company Gentiva is an industry leader in hospice, palliative, home health, and personal home care. Our place is by the side of those who need us, offering physical, spiritual and emotional support...
  • 25 Days Ago

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IDD Utilization Management Supervisor (Hybrid Option)
  • Partners Health Management
  • Mocksville, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and si...
  • 28 Days Ago

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I/DD Utilization Management Reviewer QP (Hybrid Option)
  • Partners Health Management
  • Kannapolis, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and si...
  • 10 Days Ago

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I/DD Utilization Management Reviewer QP (Hybrid Option)
  • Partners Health Management
  • Mocksville, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and si...
  • 10 Days Ago

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I/DD Utilization Management Reviewer QP (Hybrid Option)
  • Partners Health Management
  • Statesville, NC FULL_TIME
  • Competitive Compensation & Benefits Package! Position eligible for – Annual incentive bonus plan Medical, dental, and vision insurance with low deductible/low cost health plan Generous vacation and si...
  • 10 Days Ago

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0 Utilization Review Coordinator jobs found in Salisbury, NC area

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Quality & Patient Experience Coordinator-Physician Services
  • Frye Regional Medical Center
  • Statesville, NC
  • Job Summary Responsible for developing, implementing, and evaluating an operational plan in physician practices that sup...
  • 4/25/2024 12:00:00 AM

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Referral Coordinator-Frye Regional Physicians
  • Frye Regional Medical Center
  • Statesville, NC
  • Job Description: The Referral Coordinator is responsible for the coordination, processing, obtaining prior authorization...
  • 4/25/2024 12:00:00 AM

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Utility Coordinator Manager
  • CES Group Engineers, LLP
  • Charlotte, NC
  • CES is looking for a ambitious, passionate, Utility Coordinator Manager to join our relationship inspired, regionally re...
  • 4/24/2024 12:00:00 AM

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Front Desk Administrative Assistant/ Center Floater
  • Our Kids' Place LKN
  • Mooresville, NC
  • Job Description Job Description Position Purpose The front desk/administrative assistant for Our Kids' Place LKN will be...
  • 4/24/2024 12:00:00 AM

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Utility Coordinator Manager
  • Ces Group Engineers Llp
  • Charlotte, NC
  • CES is looking for a ambitious, passionate, Utility Coordinator Manager to join our relationship inspired, regionally re...
  • 4/22/2024 12:00:00 AM

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Light Equipment Operator - C&M
  • City of Winston-Salem, NC
  • Winston Salem, NC
  • Salary : $35,805.18 Annually Location : Winston-Salem, NC Job Type: Full-Time / Permanent Job Number: 06254 Department: ...
  • 4/22/2024 12:00:00 AM

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Administrative Assistant
  • T3 Live
  • Huntersville, NC
  • About Trade With the Pros: At Trade With the Pros, a subsidiary of T3 Live, we redefine the trading experience with our ...
  • 4/21/2024 12:00:00 AM

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Experienced Site-Civil Engineer
  • Leidos
  • Charlotte, NC
  • Description Leidos is seeking an Experienced Site-Civil Engineer to join our site/civil department in our growing Framin...
  • 4/10/2024 12:00:00 AM

Salisbury (/ˈsɔːlzbəri/ SAWLZ-bər-ee) is a city in the Piedmont of North Carolina; it is the county seat of Rowan County. Located 44 miles northeast of Charlotte and within its metropolitan area, the town has attracted a growing population. This was 33,663 in the 2010 Census (growing 27.8% from the Census in 2000). Founded in 1753, Salisbury is noted for its historic preservation, with five Local Historic Districts and ten National Register Historic Districts. Salisbury is the home to North Carolina soft drink, Cheerwine, regional supermarket, Food Lion and Rack Room Shoes. It is one of two ci...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$75,869 to $93,983
Salisbury, North Carolina area prices
were up 1.5% 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