Utilization Review Coordinator jobs in Kentucky
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)
Recently Added Utilization Review Coordinator jobs
Case Management Specialist - Utilization Review
- Utilization Review in Owensboro, KY - Owensboro
-
Owensboro, KY
FULL_TIME
-
Summary
Job Summary
Facilitates cost-effective, quality patient outcomes by determining the appropriate level of care and providing guidance, education, and support to assigned patients.Job Responsibilities- Assessment of complete chart and knowledge of patient's medical condition, financial status, emotional needs, and support systems.
- Conducts initial and concurrent reviews of clinical documentation for medical necessity and appropriate level of care using approved criteria within specified time frame.
- Provides appropriate clinical information to payers as requested within specified time frame.
- Collaborates with the Physician, Medical Director, Director, Manager, and Supervisor of Case Management on patients who are not meeting the regulatory requirements for hospitalization.
- Delivers regulatory letters to patients as needed.
- Provides education and acts as a resource for physicians, staff, and patients/families regarding utilization review processes.
- Trains new case managers, students, and interns as needed.
Qualifications- Associate's degree or higher in Nursing required upon hire AND
- Bachelor's degree or higher in Nursing required within 5 years of employment in this position
- No experience required
- RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire
Skills and Attributes- Requires critical thinking skills and decisive judgment.
- Works under minimal supervision.
- Must be able to work in a stressful environment and take appropriate action.
Physical Demands- Standing: Occasionally
- Walking: Occasionally
- Sitting: Frequently
- Lifting 0-25 lbs: Rarely
- Lifting 25-75 lbs: Never
- Lifting over 75 lbs: Never
- Carrying 0-25 lbs: Rarely
- Carrying 25-75 lbs: Never
- Carrying over 75 lbs: Never
- Pushing/Pulling 0-25 lbs: Rarely
- Pushing/Pulling 25-75 lbs: Never
- Pushing/Pulling over 75 lbs: Never
- Climbing: Rarely
- Bending/Stooping: Rarely
- Kneeling: Rarely
- Crouching/Crawling: Rarely
- Reaching: Occasionally
- Talking: Frequently
- Hearing: Occasionally
- Repetitive Foot/Leg Movements: Never
- Repetitive Hand/Arm Movements: Frequently
- Keyboard Data Entry: Frequently
- Running: Never
- Vision: Depth Perception: Frequently
- Vision: Distinguish Color: Frequently
- Vision: Seeing Far: Frequently
- Vision: Seeing Near: Frequently
Owensboro Health Core Commitments
INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.
RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.
TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.
INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.
SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.
EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service. - 1 Month Ago
Utilization Review Coordinator
- Ramey-Estep / Re-group
-
Rush, KY
FULL_TIME
- Function:The Utilization Review Coordinator (URC) has the primary responsibility of monitoring adherence to the agency’s utilization review procedures and ensuring appropriate leveling of client needs...
- 10 Days Ago
Utilization Review Case Coordinator
- UHS
-
LEXINGTON, KY
FULL_TIME
- Responsibilities Utilization Review Case Coordinator Opportunity:Full Time, Day Shift The Case Coordinator is responsible for managing and coordinating the treatment activities offered to the patient,...
- 1 Month Ago
Utilization Review Nurse
- St. Claire HealthCare
-
Morehead, KY
FULL_TIME
- The role of the Utilization Review Nurse actively supports the management of a successful compliant utilization review program through planning, process evaluation, data analysis and establishing goal...
- 14 Days Ago
Utilization Review Clinician
- Addiction Recovery Care
-
Louisa, KY
FULL_TIME
- About Addiction Recovery CareAt Addiction Recovery Care we incorporate the best practices of clinical drug addiction treatment. We provide addiction recovery that works with a commitment to provide ho...
- 1 Month Ago
Utilization Management Specialist 1
- SUN BEHAVIORAL HEALTH GROUP
-
Erlanger, KY
OTHER
- Job Details Job Location: SUN Behavioral Kentucky - Erlanger, KY Position Type: Part Time Education Level: High School/GED Salary Range: Undisclosed Travel Percentage: None Job Shift: Days Job Categor...
- 1 Month Ago
Utilization Review Coordinator jobs at Popular Companies
Utilization Review Coordinator
- Foundations Behavioral Health
-
Doylestown, PA
- Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Departmen...
- 4/25/2024 12:00:00 AM
Utilization Review Coordinator / Case Management / PRN
- Christus Health
-
Santa fe, NM
- Description POSITION SUMMARY: Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine t...
- 4/24/2024 12:00:00 AM
Utilization Review Coordinator (Remote Position)
- BayMark Health Services
-
Deerfield Beach, FL
- Description Position at BayMark Health Services Residential - Utilization Review Coordinator Role and Responsibilities M...
- 4/23/2024 12:00:00 AM
Utilization Review Coordinator
- Foundations Behavioral Health
-
Doylestown, PA
- Foundations Behavioral Health is currently hiring a full-time Utilization Review Coordinator to support our UM Departmen...
- 4/22/2024 12:00:00 AM
Utility Supervisor
- Transdev Inc.
-
Fairfax, VA
- Utility Supervisor Job Description OVERVIEW: The Utility Supervisor reports directly to the Maintenance Manager in fulfi...
- 4/22/2024 12:00:00 AM
Utilities Supervisor
- System One Holdings, LLC
-
Hightstown, NJ
- SUMMARY Perform periodic maintenance of utilities equipment. Responsible for HVAC, water system and Boiler area day to d...
- 4/22/2024 12:00:00 AM
Utilization Review Coordinator
- TheraMatrix
-
Pontiac, MI
- Job Description Job Description Duties and Responsibilities: Initial authorizations of outpatient physical therapy servi...
- 4/21/2024 12:00:00 AM
Utilities Supervisor
- City of Palo Alto, CA
-
Palo Alto, CA
- Salary : $156,208.00 - $208,270.40 Annually Location : Palo Alto, CA Job Type: Regular Full-Time Job Number: 202400565 D...
- 4/21/2024 12:00:00 AM
About Kentucky
Kentucky (/kənˈtʌki/ (listen) kən-TUK-ee), officially the Commonwealth of Kentucky, is a state located in the east south-central region of the United States. Although styled as the "State of Kentucky" in the law creating it, (because in Kentucky's first constitution, the name state was used) Kentucky is one of four U.S. states constituted as a commonwealth (the others being Virginia, Pennsylvania, and Massachusetts). Originally a part of Virginia, in 1792 Kentucky became the 15th state to join the Union. Kentucky is the 37th most extensive and the 26th most populous of the 50 United States.
Ke...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$75,869 to $93,983
Most Popular Cities in Kentucky for Utilization Review Coordinator Jobs
What does an Utilization Review Coordinator do?
Utilization Review Coordinator in Long Beach, CA
The Utilization Review Coordinator contributes to moderately complex aspects of a project.
January 05, 2020
Utilization Review Coordinator in Gary, IN
Candidates for this role must have a good understanding of medical terminologies, and stay tuned with latest developments in the field; they should possess knowledge of reviews such as MAC, KEPRO, and RAC; strong observing skills and the ability to monitor safety plans are also needed.
December 29, 2019
Utilization Review Coordinator in Chicago, IL
Including requirements, responsibilities, statistics, industries, similar jobs and job openings for Utilization Review Coordinator.
December 30, 2019