Utilization Review Coordinator jobs in California

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)

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Utilization Review Coordinator
  • Cazador Consulting Group Inc
  • Bakersfield, CA FULL_TIME
  • We are seeking a Case Manager RN with (5) or more years of experience working in a medical facility, hospital, or other healthcare-related environment. Along with (2) or more years of experience in case management or IPA preferred. Must have previous experience coordinating with providers, provider staff, hospital staff, patients, and patient family members to establish an appropriate level of care.

    • Knowledge of nursing processes
    • Case management and continuity of care.
    • Familiar with regulatory requirements for managed care, HMO, and EPOs.
    • Knowledge of disease management strategies
    • Managed care experience preferred.
    • Knowledge of network and benefit limitations and ability to collaborate with stakeholders to find alternatives that meet patient needs and achieve positive outcomes.

    Job Type: Full-time

    Pay: $40.00 - $50.00 per hour

    Expected hours: 40 per week

    Schedule:

    • Monday to Friday

    Work Location: Remote

  • 28 Days Ago

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Utilization Review Coordinator
  • Prime Healthcare Management Inc
  • Ontario, CA FULL_TIME
  • Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providi...
  • 2 Months Ago

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Utilization Review Coordinator, Behavioral Health
  • Community Health System - CA
  • Fresno, CA FULL_TIME
  • Overview: All positions are located in Fresno/Clovis CA* Opportunities for you! Join a Forbes Top 10 CA Employer! Free Continuing Education and certification including BLS, ACLS and PALS Tuition reimb...
  • 19 Days Ago

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Utilization Review Coordinator, Behavioral Health
  • Community Medical Centers of Fresno, CA
  • Fresno, CA OTHER
  • Overview *All positions are located in Fresno/Clovis CA* Opportunities for you! Join a Forbes Top 10 CA Employer! Free Continuing Education and certification including BLS, ACLS and PALS Tuition reimb...
  • 1 Month Ago

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Continuing Care Utilization Review Coordinator RN
  • Kaiser Permanente
  • Sacramento, CA OTHER
  • Job Summary:Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process.Essential Responsibilities:Conducts utilization r...
  • 20 Days Ago

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HHS Utilization Review Coordinator - Behavioral Health
  • County of Napa
  • Napa, CA FULL_TIME
  • Napa County is home to 140,000 residents who share a strong sense of community and a legacy of preserving and protecting our rich agricultural heritage. Located in the heart of California's preeminent...
  • 1 Day Ago

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Utilization Review Coordinator (Part-time, Not Remote) Opioid Treatment Program
  • UHS
  • Greenwood, IN
  • Responsibilities WHO WE ARE Valle Vista Health System (a UHS affiliated facility) is a 132-bed, acute care psychiatric h...
  • 3/28/2024 12:00:00 AM

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Utilization Review Coordinator
  • TheraMatrix
  • Pontiac, MI
  • Job Description Job Description Duties and Responsibilities: Initial authorizations of outpatient physical therapy servi...
  • 3/28/2024 12:00:00 AM

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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...
  • 3/28/2024 12:00:00 AM

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Utilization Reviewer Coordinator
  • NeuroBehavioral Hospitals
  • West Palm Beach, FL
  • You Matter: Make a difference every day in the lives of the underserved Join a mission driven organization with a people...
  • 3/26/2024 12:00:00 AM

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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...
  • 3/25/2024 12:00:00 AM

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TEMP FT UTILIZATION REVIEW COORDINATOR
  • UHS
  • Jacksonville, FL
  • Responsibilities Universal Health Services, Inc. , one of the nation's largest and most respected providers of hospital ...
  • 3/25/2024 12:00:00 AM

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Utility Coordinator
  • KEITH
  • Miami, FL
  • Utility Coordinator - Miami, FL KEITH is seeking a Utility Coordinator to join our Miami, FL office to strengthen our gr...
  • 3/25/2024 12:00:00 AM

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Refrigeration/Utilities Supervisor
  • The Judge Group
  • New Castle, IN
  • Hiring Company: Boar's Head Provisions Co., Inc.Overview:Reporting directly to the Facility Manager, this position is re...
  • 3/24/2024 12:00:00 AM

California is a state in the Pacific Region of the United States. With 39.6 million residents, California is the most populous U.S. state and the third-largest by area. The state capital is Sacramento. The Greater Los Angeles Area and the San Francisco Bay Area are the nation's second and fifth most populous urban regions, with 18.7 million and 9.7 million residents respectively. Los Angeles is California's most populous city, and the country's second most populous, after New York City. California also has the nation's most populous county, Los Angeles County, and its largest county by area, S...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$88,979 to $110,214

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