Utilization Review Coordinator jobs in New York

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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Coordinator Utilization Review & Quality Monitor
  • Rochester Regional Health Careers
  • Rochester, NY FULL_TIME
  • SUMMARY

    Under the direction of the Director of Mental Health Services, coordinates all activities related to the mental health utilization review program and quality record documentation monitoring.

    ATTRIBUTES

    • NYS OMH qualified health professional.
    • Valid clinical credential and/or licensure with valid registration maintained in good standing required.
    • Master’s degree in a mental health discipline.

    RESPONSIBILITIES

    • Completes admission and continued stay utilization reviews for assigned programs as outlined in the Mental Health Utilization Review policy and procedure.
    • Collaborates and communicates with site managers on an ongoing basis regarding documentation and recording concerns and utilization review outcomes. Assists in the development of actions to address identified concerns to improve outcomes.
    • Complete monthly UR tracking information and final report and maintain all necessary documentation as outlined by NYS office of mental health regulations and health system policy.
    • Involvement in QI activities as assigned including the review of record documentation, trend tracking, and analysis of outcomes.
    • Assist with the implementation of clinical guidelines and initiatives at the outpatient program level.
    • Implements staff instruction and training opportunities.
    • Remains knowledgeable and aware of regulatory changes and assists programs with documentation implementation needs as directed by the director of mental health services.
    • Computer keyboard skills and ability to utilize computers to record activities, access necessary data and reports.

    EDUCATION:

    • MS (Required)

    PHYSICAL REQUIREMENTS: S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

    LICENSES/CERTIFICATIONS:

    • QHP - Qualified Health Professional - NYS Office of Alcoholism and Substance Abuse Services (OASAS)

    PAY RANGE: $65,000.00 - $85,000.00

  • 4 Days Ago

S
Performance Optimization Coordinator/Utilization Review Specialist
  • Schuyler Hospital
  • Montour, NY FULL_TIME
  • WORK AND LIVE WHERE OTHERS VACATION!! We will deliver the highest quality health care in partnership with our community, one person at a time. CAYUGA HEALTH SYSTEM Montour Falls, NY 1.5 hours from Syr...
  • 1 Month Ago

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Case Manager/Utilization Review
  • Midas Consulting
  • White Plains, NY CONTRACTOR
  • Understands and adheres to the WPH Performance Standards, Policies and Behaviors Completes a comprehensive initial assessment. Performs all activities for multidisciplinary care coordination at the in...
  • 8 Days Ago

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Utilization Review Nurse
  • Hamaspik Choice
  • Spring, NY FULL_TIME
  • The UM Nurse manages providers, members, or care manager generated requests for medical services and renders clinical determinations in accordance with Hamaspik Choice policies as well as applicable s...
  • 12 Days Ago

C
Utilization Review Specialist
  • Charlie Health Strategy & Operations
  • New York, NY FULL_TIME
  • About the Role The purpose of this position is to ensure that the utilization process is thorough, organized and streamlined to provide the best possible length of stays for our patients. Given the co...
  • 12 Days Ago

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Utilization Review Registered Nurse
  • Crouse Hospital
  • Syracuse, NY FULL_TIME
  • Utilization Management RN has well-developed knowledge and is proficient with standard Utilization Review processes. The Utilization Management RN is an integral part of the multidisciplinary team, an...
  • Just Posted

New York is a state in the Northeastern United States. New York was one of the original thirteen colonies that formed the United States. New York covers 54,555 square miles (141,300 km2) and ranks as the 27th largest state by size.[3] The highest elevation in New York is Mount Marcy in the Adirondacks, at 5,344 feet (1,629 meters) above sea level; while the state's lowest point is at sea level, on the Atlantic Ocean. In contrast with New York City's urban landscape, the vast majority of the state's geographic area is dominated by meadows, forests, rivers, farms, mountains, and lakes. Most of...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$85,948 to $106,467

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