Utilization Review Manager - Home Care jobs in Altoona, PA

Cove Forge is actively hiring a Utilization Review Specialist to act as a liaison between managed care organizations and the facility professional clinical staff.

Benefits:

• Comprehensive Benefit Package
• 401K Match
• Paid Holidays
• Paid Time Off

Position Requirements:

• HS Diploma or GED
• Professional and courteous demeanor
• Basic computer knowledge and emails/charting

Essential Functions:

• Act as a liaison between managed care organizations and the facility professional clinical staff.
• Monitor patient length of stay and extensions.
• Inform clinical and medical staff on issues that may impact length of stay.
• Conduct quality reviews for medical necessity and services provided.
• Initiate and complete formal appeal process for denied admissions or continued stay.
• Assist the admissions department pre-certifications of care.

Cove Forge Williamsburg is an EOE.

Education

• High School/GED or better

Skills

• Problem Solving
• Typing
• Attention to Detail
• Communication

Behaviors

• Dedicated: Devoted to a task or purpose with loyalty or integrity
• Team Player: Works well as a member of a group

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)