Utilization Review Coordinator jobs in Mississippi
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
RN-Utilization Review - DC Case Management Admin BMH Desoto
- Baptist
-
Southaven, MS
FULL_TIME
-
Summary
The Utilization Review Nurse is responsible for evaluating the medical necessity and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies and patients to ensure cost-effective and appropriate care. Areas of work include status management, medical necessity reviews, verification of authorization, resource utilization, and denial prevention.
Responsibilities- Completes and enters inpatient and observation admission review against standard criteria per payer guidelines
- Prioritizes observation case review
- Assists with level of care in collaboration with attending provider
- Enters working diagnosis-related groups (DRGs) in the electronic medical record
- Submits clinical information to payer per payer requirements
- Completes continued stay reviews every 3 days or more often if required
- Communicates with care coordinators for authorized days, level of care, medical necessity or other areas when indicated
- Communicates with physician advisors related to status concerns or denials
- Updates auth/cert screen in the electronic medical record
- Works assigned queues in the electronic medical record
- Communicates with authorization coordinator
- Communicates in-house high dollar case information
Completes assigned goals
Requirements, Preferences and Experience
Experience Minimum:
RN with 3 years of clinical experience
Experience Preferred:
RN with 3 years of clinical experience
Education Minimum:
Diploma or Associate Degree in Nursing
Education Preferred:
BSN or MSN
Special Skills Minimum:
Critical thinking skills, clinical knowledge, attention to detail communication, organization, interpersonal, time management and computer skills. Problem solving; and knowledge of governmental regulations.
Licensure Minimum:
RN
Licensure Preferred:
CCM;ACM
About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.
At Baptist, We Offer:- Competitive salaries
- Paid vacation/time off
- Continuing education opportunities
- Generous retirement plan
- Health insurance, including dental and vision
- Sick leave
- Service awards
- Free parking
- Short-term disability
- Life insurance
- Health care and dependent care spending accounts
- Education assistance/continuing education
- Employee referral program
Job Summary:
Position: 18447 - RN-Utilization Review
Facility: BMH - Desoto Hospital
Department: DC Case Management Admin BMH Desoto
Category: Nurse RN
Type: Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:MS:Southaven
Located in the Memphis metro area - 19 Days Ago
Supervisory Acquisition and Utilization Specialist
- Veterans Health Administration
-
Jackson, MS
FULL_TIME
- The Supervisory Acquisition Utilization Specialist serves as a liaison and advisor on contract related services focusing on critical clinical and healthcare services, facility and environmental servic...
- 8 Days Ago
Commercial Review Appraiser
- HB001 Hancock Whitney Bank
-
Gulfport, MS
FULL_TIME
- Thank you for your interest in our company! To apply, click on the button above. You will be required to create an account (or sign in with an existing account). Your account will provide you access t...
- Just Posted
Plan Review Technician
- City of Gulfport
-
GULFPORT, MS
FULL_TIME
- Plan Review Technician FLSA Status: Non-Exempt Position Overview The Plan Review Technician performs a variety of routine clerical, technical, and administrative functions in the Plan Review Division ...
- 10 Days Ago
Paid Product Tester
- Product Review Jobs
-
Brooklyn, MS
FULL_TIME
- Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
- Just Posted
Paid Product Tester
- Product Review Jobs
-
Sandersville, MS
FULL_TIME
- Compensation: Varies per assignment. Up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsThank you for your interest in becoming a Paid Product Tester. This opportunity is for completi...
- Just Posted
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 Mississippi
Mississippi is bordered to the north by Tennessee, to the east by Alabama, to the south by Louisiana and a narrow coast on the Gulf of Mexico; and to the west, across the Mississippi River, by Louisiana and Arkansas.
In addition to its namesake, major rivers in Mississippi include the Big Black River, the Pearl River, the Yazoo River, the Pascagoula River, and the Tombigbee River. Major lakes include Ross Barnett Reservoir, Arkabutla Lake, Sardis Lake, and Grenada Lake with the largest lake being Sardis Lake.
Mississippi is entirely composed of lowlands, the highest point being Woodall Mountai...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$71,919 to $89,089
Most Popular Cities in Mississippi 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