Utilization Review Coordinator jobs in Kalamazoo, MI

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 specialist
  • Oaklawn Hospital
  • Marshall, MI FULL_TIME
  • Job Summary :

    Performs utilization review with external agencies to ensure payment for medically necessary inpatient services.

    Essential Functions :

    • Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his / her goals and objectives in a manner that helps others to achieve their goals and objectives.
    • Performs ongoing review of charts for inpatient psychiatric patients and partial hospitalization patients based on approved utilization review criteria.
    • Refers utilization review issues to physician advisor and treatment team as appropriate
    • Appeals denied psychiatric days according to approved procedures.
    • Maintains up-to-date information regarding requirements of individual insurance companies, and ensures these requirements are met.
    • Participates in hospital utilization review committees as appropriate to psychiatric utilization review duties.
    • Documents all communications and updates accordingly.
    • Maintains stats regarding denied / uncovered days and length of stay.
    • Delivers and tracks the Important Message from Medicare form.
    • Acts as the court liaison.
    • Assists as needed with phone intakes.

    Minimum Qualifications : Bachelor’s degree or commensurate experience in a related field of Psychology or Utilization Review.

    Completion of Handle with Care Basic Certification in physical and nonverbal patient management within two months of hire with annual re-certification.

    Knowledge, Skills & Abilities : Master’s degree in Psychology, preferred. Previous experience with utilization review, case management or telephone triage desired.

    Familiarity with electronic medical records and medical terminology.

    Physical Requirements : Constantly sit, see / visual acuity, handle / grasp / feel, talk / hear, lift / carry 1 to 25 lbs.

    Frequently stand, walk, reach, bend / twist, lift / carry 25 to 49 lbs. Occasionally lift / carry 50 lbs.

    Last updated : 2024-03-23

  • 3 Days Ago

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Utilization Review Nurse
  • Neuropsychiatric Hospitals
  • Kalamazoo, MI FULL_TIME
  • About Us HEALING THE BODY AND MIND Founded fifteen (15) years ago, NeuroPsychiatric Hospital is the largest hospital system in the nation providing care to patients with both neurological and medical ...
  • 7 Days Ago

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Revenue Utilization Review Nurse
  • US Veterans Health Administration
  • Battle Creek, MI FULL_TIME
  • Duties VA offers a comprehensive total rewards package: VA Nurse Total Rewards The RUR nurse is under the supervision of a Nurse Manager, Assistant Nurse Manager, or designee, who provides the adminis...
  • 1 Month Ago

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Utilization Review Specialist. Monday-Friday dayshift hours
  • Oaklawn Hospital
  • Marshall, MI FULL_TIME
  • Job Summary: Performs utilization review with external agencies to ensure payment for medically necessary inpatient services. Essential Functions: Consistently uses an outward mindset and puts forth e...
  • Just Posted

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Utilization Review Specialist-casual position with variable dayshift hours
  • Oaklawn Hospital
  • Marshall, MI FULL_TIME
  • Job Summary: Performs utilization review with external agencies to ensure payment for medically necessary inpatient services. Essential Functions: Consistently uses an outward mindset and puts forth e...
  • 1 Day Ago

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Utilization Review Specialist-Dayshift position, hours are flexible to unit need
  • Oaklawn Hospital
  • Marshall, MI FULL_TIME
  • Job Summary: Performs utilization review with external agencies to ensure payment for medically necessary inpatient services. Essential Functions: Consistently uses an outward mindset and puts forth e...
  • 3 Days Ago

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0 Utilization Review Coordinator jobs found in Kalamazoo, MI area

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Design Architect
  • Tower Pinkster
  • Kalamazoo, MI
  • Join our team at TowerPinkster and open a new door to an amazing career! TowerPinkster, an architecture, engineering and...
  • 3/28/2024 12:00:00 AM

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Medical First Responder Instructor
  • Ladgov Corporation
  • Kalamazoo, MI
  • Job Title: Medical First Responder Instructor Location : Battle Creek , MI 49037 Job Type : Part-Time Position Overview:...
  • 3/28/2024 12:00:00 AM

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Inside Sales Specialist
  • Polytek Development Corp
  • Kalamazoo, MI
  • Polytek® Development Corp. is a leading manufacturer of mold making and casting materials. Polytek® is currently looking...
  • 3/27/2024 12:00:00 AM

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Account Manager- Southern California (REMOTE)
  • Kalsec, Inc.
  • Kalamazoo, MI
  • Job Summary: Protect and grow assigned accounts through consultative, strategic selling techniques and prospecting for n...
  • 3/27/2024 12:00:00 AM

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Registered Nurse (RN) Med/Surg Units Full Time - Kalamazoo
  • Bronson Healthcare
  • Kalamazoo, MI
  • CURRENT BRONSON EMPLOYEES - Please apply using the career worklet in Workday. This career site is for external applicant...
  • 3/27/2024 12:00:00 AM

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MDS Coordinator
  • The Laurels of Bedford
  • Battle Creek, MI
  • $10,000 Sign-On Bonus Are you an experienced MDS nurse interested in the next step? The MDS Coordinator provides oversig...
  • 3/26/2024 12:00:00 AM

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Director, Information Security Consultant
  • Capital One
  • Kalamazoo, MI
  • Center 1 (19052), United States of America, McLean, Virginia Director, Information Security Consultant At Capital One, y...
  • 3/26/2024 12:00:00 AM

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Field Based Community Health Worker
  • UnitedHealthcare
  • Kalamazoo, MI
  • At UnitedHealthcare, were simplifying the health care experience, creating healthier communities, and removing barriers ...
  • 3/26/2024 12:00:00 AM

Most of Kalamazoo is on the southwest bank of a major bend in the Kalamazoo River, with a small portion, about 2.8 square miles (7.3 km2), on the opposite bank. Several small tributaries of the Kalamazoo River, including Arcadia Creek and Portage Creek, wind through the city. The northeastern portion of Kalamazoo sits in the broad, flat Kalamazoo Valley, while the western portions of Kalamazoo climb into low hills to the west and south. Several small lakes are found throughout the area. According to the United States Census Bureau, Kalamazoo has a total area of 25.11 square miles (65.03 km2), ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$78,723 to $97,511
Kalamazoo, Michigan area prices
were up 1.3% from a year ago

Utilization Review Coordinator in Fort Lauderdale, FL
Some review coordinator positions require that professionals have training and experience within a more specific field.
January 10, 2020
Utilization Review Coordinator in Asheville, NC
Schick Shadel Hospital is seeking a part-time (20 hours per week) Utilization Review Coordinator (UR Coordinator) to help oversee and perform the process of utilization review to ensure appropriate reimbursement by third party payers.
January 04, 2020
Utilization Review Coordinator in Jacksonville, FL
Excellent benefits, pay, small on-site employee gym, wonderful co-workers and managersFull Review.
January 04, 2020