Utilization Review Technician jobs in the United States
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)
Recently Added Utilization Review Technician jobs
Case Management Specialist - Utilization Review
- Utilization Review in Owensboro, KY - Owensboro
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Owensboro, KY
FULL_TIME
-
Summary
Job Summary
Facilitates cost-effective, quality patient outcomes and transitions 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 Attending Physician, Physician Advisor, Director, Manager, or Supervisor of Case Management on patients who are not meeting the regulatory requirements for hospitalization and delays in services and/or discharge.
- Delivers regulatory letters to patients as needed.
- Works in collaboration with the interdisciplinary team to ensure quality support of care and resource information
- May assist patients/families with referrals to community agencies, post-acute providers, and/or provide education and resources.
- Provides education and acts as a resource for physicians, staff, and patients/families regarding case management 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: Frequently
- Walking: Frequently
- Sitting: Frequently
- Lifting 0-25 lbs: Frequently
- Lifting 25-75 lbs: Rarely
- Lifting over 75 lbs: Rarely
- Carrying 0-25 lbs: Frequently
- Carrying 25-75 lbs: Rarely
- Carrying over 75 lbs: Rarely
- Pushing/Pulling 0-25 lbs: Frequently
- Pushing/Pulling 25-75 lbs: Frequently
- Pushing/Pulling over 75 lbs: Frequently
- Climbing: Occasionally
- Bending/Stooping: Frequently
- Kneeling: Occasionally
- Crouching/Crawling: Occasionally
- Reaching: Frequently
- Talking: Frequently
- Hearing: Frequently
- Repetitive Foot/Leg Movements: Rarely
- Repetitive Hand/Arm Movements: Frequently
- Keyboard Data Entry: Frequently
- Running: Occasionally
- 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. - 11 Days Ago
Inpatient Utilization Review Nurse (Registered Nurse)
- Utilization Management
-
Holly, FL
FULL_TIME
- Inpatient Utilization Review Nurse (Registered Nurse)Utilization ManagementFull-timeMonday - Friday 8am - 5pmApplicants must live in Volusia or Flagler Counties to be Considered. UM department functio...
- 2 Months Ago
RN Coordinator-Utilization Review/Full Time/Remote
- Utilization Review/Full Time/Remote - Henry Ford Health - Careers Careers
-
Troy, MI
FULL_TIME
- Location - Remote Hours are 8 hour shifts, with hours of operation from 7:30am until 6:30pm, No holidays and working Monday through Friday with a rotating weekend schedule of every 5th weekend. Under ...
- 3 Days Ago
Utilization review
- ECU Health
-
Greenville, NC
FULL_TIME
- ECU Health Physicians and ECU Health Medical Center, located in Greenville, North Carolina, are seeking a Physician Assistant to work as a Utilization Review Advisor. The successful applicants will be...
- 1 Day Ago
Utilization Management/Utilization Review
- Windmill Wellness Ranch LLC
-
Canyon, TX
FULL_TIME
- Windmill Wellness opened the Ranch in May of 2017. We are nestled in the Texas Hill Country and are sitting on 76 acres. The mission of Windmill Wellness Ranch Is to improve the physical, spiritual an...
- 2 Months Ago
Utilization Review Nurse - Utilization Management
- METROHEALTH MEDICAL CENTER
-
Cleveland, OH
FULL_TIME
- Location: METROHEALTH MEDICAL CENTER Biweekly Hours: 64.00 Shift: variable start time, day shift The MetroHealth System is redefining health care by going beyond medical treatment to improve the found...
- 12 Days Ago
Utilization Review Technician jobs at Popular Companies
Maximo Technical Specialist
- Harvest Technical Services, Inc.
-
La Verne, CA
- Job Description Job Description *This position is hybrid in La Verne, CA Job Description: We’re looking for someone who ...
- 5/19/2024 12:00:00 AM
Space Test & Evaluation Technical Expert
- Modern Technology Solutions, Inc.
-
Mount Wilson, CA
- Own Your Future. Modern Technology Solutions, Inc. (MTSI) is seeking a Space Test & Evaluation Technical Expert to join ...
- 5/17/2024 12:00:00 AM
Space Test & Evaluation Technical Expert
- Modern Technology Solutions, Inc.
-
Lancaster, CA
- Own Your Future. Modern Technology Solutions, Inc. (MTSI) is seeking a Space Test & Evaluation Technical Expert to join ...
- 5/17/2024 12:00:00 AM
Space Test & Evaluation Technical Expert
- Modern Technology Solutions, Inc.
-
Canyon Country, CA
- Own Your Future. Modern Technology Solutions, Inc. (MTSI) is seeking a Space Test & Evaluation Technical Expert to join ...
- 5/17/2024 12:00:00 AM
Space Test & Evaluation Technical Expert
- Modern Technology Solutions, Inc.
-
Palmdale, CA
- Own Your Future. Modern Technology Solutions, Inc. (MTSI) is seeking a Space Test & Evaluation Technical Expert to join ...
- 5/17/2024 12:00:00 AM
Space Test & Evaluation Technical Expert
- Modern Technology Solutions, Inc.
-
Valyermo, CA
- Own Your Future. Modern Technology Solutions, Inc. (MTSI) is seeking a Space Test & Evaluation Technical Expert to join ...
- 5/17/2024 12:00:00 AM
High Tech Specialist Trainee
- Consolidated Electrical Distributors
-
Santa Fe Springs, CA
- Summary Job title: High Tech Specialist Trainee Job ID: 202497680002 Department: So. Cal TRC Location: CA-Santa Fe Sprin...
- 5/17/2024 12:00:00 AM
Field Tech Specialist- California
- AXYZ
-
Anaheim, CA
- It is an exciting time at AAG as we work to achieve our vision of being the global leader in tailored cutting solutions ...
- 5/16/2024 12:00:00 AM
Income Estimation for Utilization Review Technician jobs
$63,075 to $88,008