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)
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:
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.
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