Utilization Review Technician 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 Technician 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 Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
At Ashe Memorial Hospital, we are driven by our Mission Statement, "To meet the needs of the community by delivering patient-centered, high quality health care."
Ashe Memorial Hospital is proud to be Voted Ashe's Best Place to Work 2022 & 2023! Come be a part of our dynamic team; you'll join Ashe's 2022 & 2023 Best Hospital, Best Surgeon, Best Physician, Best Nurse, and Best Medical Practice! This is your opportunity to make a large difference in a small community!
Hours & Days Vary - PRN (as needed) weekends & holidays required | No Supervisory Responsibilities | No Travel | Pay commensurate with experience.
JOB SUMMARY: Utilization Review/Patient Care Coordinator (UR/PCC) is responsible for the coordination and management of the Ashe Memorial Transitional Care Services program, also known as Swing Bed. This includes managing the referral process, both internal and external, as well as marketing and outreach to other facilities. The UR/PCC is also responsible for all Utilization Review activities within Ashe Memorial Hospital. This individual will be responsible to ensure that both the TCS program and Utilization Review meets all regulatory compliance from accrediting agencies. Performs all work with accordance to the mission, vision and values of Ashe Memorial Hospital (AMH).
Minimum Job Qualifications:
Certifications/Education:
Experience:
ESSENTIAL FUNCTIONS:
Must be willing to receive all required vaccinations (i.e., flu shot, etc.). All new employees working must be fully vaccinated as a condition of employment (unless the new hire has requested and received an exemption). Candidates for employment will be notified of this policy requirement prior to the start of employment. After receiving an offer of employment, new employees must provide proof of vaccination or request and receive an exemption before beginning work.
To apply, please fill out an application, attach a cover letter, and resume. Include gaps in employment and reasons for separation.
Criminal background check and pre-employment drug screen required upon conditional job offer.
***Benefits apply the 1st of the month following employment, per policy.***
*For full job description and benefits, please contact Human Resources.
Ashe Memorial Hospital is an equal opportunity employer and, as such, considers individuals for employment according to their abilities and performance. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care. Employment decisions are made without regard to race, age, religion, color, sex, national origin, physical or mental disability, marital or veteran status, sexual orientation, genetic information, or any other classification protected by law. All employment requirements mandated by local, state, and federal regulations will be observed.