Utilization Review Coordinator jobs in Mckinney, TX

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
  • LifeCare Health
  • Dallas, TX FULL_TIME
  • We have an immediate opportunity for a Utilization Review Coordinator.

    General Summary: The Utilization Review Coordinator will monitor adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital services and monitor the appropriateness of hospital admissions and extended hospitals stays. The Utilization Review Coordinator is actively involved in department activities, transdisciplinary team activities, and LifeCare activities to ensure individualized, patient-centered health care for all patient populations admitted to LifeCare Hospital.

    Patient Population: Has contact with patients in a clinical setting; understands and demonstrates appropriate behavior when interacting with patients in the adult (18-65 years of age) and geriatric (65 and older) populations.

    Essential Job Functions:

    • Establishes and maintains efficient methods of ensuring the medical necessity and appropriateness of hospital admissions. Conducts pre-certifications as needed.
    • Conducts initial and concurrent reviews with payers to ensure that extended stays are medically justified and are so documented in patient's medical records. Facilitates concurrent in house physician peer to peer reviews, and concurrent expedited appeals and referrals to LifeCare Authorization and Appeals team at appropriate.
    • Open cases in the correct level of care. Calculates the lengths of stay and continued-stay days for patients.
    • Responsible for tracking reviews and ensuring they are called in within the identified time frame.
    • Responsible for updating authorizations/denials in the medical billing system.
    • Responsible for communicating authorizations/denials to the transdisciplinary team and partnering departments.
    • Maintains communication with Case Managers to facilitate timely discharge planning. Responsible for communicating discharges with identified payers.
    • Participates in the education of departments regarding utilization review needs and processes.
    • Compiles monthly reports and statistics for presentation to facility leadership.
    • The knowledge and skills necessary to perform the position requirements are demonstrated through the successful completion of competencies established for the position, to include population served and other special needs of patients or customers, served by the department.
    • Adheres to LifeCare policies, procedures, all safety plans, and all standards imposed by regulatory organizations.
    • Regular attendance and timeliness is required.

    This description is a general statement of required essential functions performed on a regular and continuous basis. It does not exclude other duties as assigned.

    Requirements

    Supervision: Does not direct or supervise the functions of the department.

    Experience: One to two years’ experience in Utilization Review or Case Management in a healthcare setting.

    Education: Graduate of an accredited technical school of nursing or an approved Registered Nurse program is required.

    Licensure/Certification: Currently licensed as a Licensed Vocational/Practical Nurse or Registered Nurse in state where currently practicing. All Utilization Review Coordinators must maintain current licensure while employed with LifeCare Hospitals.

  • 1 Day Ago

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Regional Utilization Review Coordinator
  • Oceans Healthcare
  • Plano, TX FULL_TIME
  • The Regional Utilization Review Coordinator is responsible for management of all utilization review and/or case management activities at the assigned inpatient facilities. May include partial hospital...
  • 5 Days Ago

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Utilization Review Coordinator - PRN
  • LifeCare Management Services
  • Dallas, TX OTHER
  • Job Title Utilization Review Coordinator - PRN Posted 5/27/2023 Location LifeCare Hospitals of Dallas 1950 Record CrossingDallas, TX 75235 Description We have an immediate opportunity for a Utilizatio...
  • 10 Days Ago

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Utilization Review Specialist
  • Carrollton Springs
  • Frisco, TX FULL_TIME
  • Overview Carrollton Springs-Frisco Carrollton Springs Changes is a behavioral hospital located in Frisco, TX. The hospital offers inpatient and outpatient mental health and addiction treatment to adul...
  • 19 Days Ago

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Utilization Review Specialist
  • Springstone, Inc.
  • Frisco, TX FULL_TIME
  • Overview Carrollton Springs-Frisco Carrollton Springs Changes is a behavioral hospital located in Frisco, TX. The hospital offers inpatient and outpatient mental health and addiction treatment to adul...
  • 21 Days Ago

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Utilization Review RN
  • TEXAS INSTITUTE FOR SURGERY
  • Dallas, TX OTHER
  • Job Details Job Location: Texas Institute for Surgery LL SURG - Dallas, TX Salary Range: $38.00 - $43.00 Hourly Job Category: Health Care DescriptionJob Summary: The Utilization Management Nurse will ...
  • 24 Days Ago

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0 Utilization Review Coordinator jobs found in Mckinney, TX area

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Mid-Level OneStream Consultant
  • ManTech
  • Secure our Nation, Ignite your Future ManTech is seeking dedicated and enthusiastic Mid-level OneStream Consultants to j...
  • 3/27/2024 12:00:00 AM

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Mid-Level OneStream Consultant
  • ManTech
  • Secure our Nation, Ignite your Future ManTech is seeking dedicated and enthusiastic Mid-level OneStream Consultants to j...
  • 3/26/2024 12:00:00 AM

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Senior Medical Science Liaison-Women's Healthcare Mid Atlantic DC/VA
  • Bayer
  • Sr MSL WHC Mid Atlantic DC/VA The Senior Medical Science Liaison (MSL) serves as a trusted scientific expert and partner...
  • 3/25/2024 12:00:00 AM

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Senior Medical Science Liaison-Women's Healthcare Mid Atlantic DC/VA
  • Bayer
  • Sr MSL WHC Mid Atlantic DC/VA The Senior Medical Science Liaison (MSL) serves as a trusted scientific expert and partner...
  • 3/25/2024 12:00:00 AM

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Senior Medical Science Liaison-Women's Healthcare Nevada Utah
  • Bayer
  • At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where 'Health for a...
  • 3/25/2024 12:00:00 AM

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Senior Medical Science Liaison-Women's Healthcare Nevada Utah
  • Bayer
  • At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where 'Health for a...
  • 3/25/2024 12:00:00 AM

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Senior Medical Science Liaison-Women's Healthcare Northern California
  • Bayer
  • At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where 'Health for a...
  • 3/25/2024 12:00:00 AM

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Senior Medical Science Liaison-Cardiorenal Charleston South Carolina
  • Bayer
  • At Bayer we’re visionaries, driven to solve the world’s toughest challenges and striving for a world where 'Health for a...
  • 3/25/2024 12:00:00 AM

McKinney is a city in and the county seat of Collin County, Texas, United States. It is Collin County's second-largest city, after Plano. Part of the Dallas-Fort Worth metroplex, McKinney is about 32 miles (51 km) north of Dallas. The Census Bureau listed McKinney as the nation's fastest-growing city from 2000 to 2003 and again in 2006, among cities with more than 50,000 people. In 2007, it was ranked second-fastest-growing among cities with more than 100,000 people and in 2008 as third-fastest. In the 2010 census, the city's population was 131,117, making it Texas's 19th-most populous city. T...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$79,887 to $98,953
Mckinney, Texas area prices
were up 2.2% 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