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)
Full-Time Utilization Review/Risk Management Registered Nurse needed at a great hospital in beautiful northern New York
SIGN ON BONUS
POSITION TITLE: Quality Specialist
DEPARTMENT: Quality Management
REPORTS TO: Director of Quality Management
Job purpose: Provides Utilization Review and approval during the admission process and provides clinical information as required to Insurance Companies at admission and during stay. Works closely with Revenue Cycle staff and Discharge Planning to assist in the review and acceptance into the sub-acute rehab program. Coordinates the Quality Improvement monthly meetings and subsequent reports. Also coordinates the Risk Management process.
Qualifications:
Registered Nurse with current NYS License
Preferred experience with QI/Risk Management/Utilization Review/Infection Control
BSN Preferred
Familiar with agency support availability
PRI certification or within six months of employment
Offering competitive compensation and complete benefits.
For more information, please submit your resume for review
0 Utilization Review Coordinator jobs found in Utica, NY area