Utilization Review Coordinator jobs in West Bloomfield, 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 Nurse
  • LanceSoft Inc
  • Detroit, MI FULL_TIME,CONTRACTOR
  • Job Description:
    • This position will be remote role for Nurses in Michigan
    • Should have a valid MI RN License
    • Should Have utilization management experience.
    • Should have experience completing post-acute reviews for the inpatient rehab, skilled nursing facility settings previously.
    • The candidate should be well versed in coordination of care activities along with discharge planning which is a plus for this role in ensuring members are transitioned safely following care.
    • In addition, the candidate should have knowledge of post-acute InterQual criteria that is utilized in this role.
    Requirements:
    • Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes.
    • One year health insurance plan experience or managed care environment preferred. Registered Nurse with current unrestricted Michigan Registered Nurse license required.
    • Certification in Case Management may be preferred based upon designated department assignment.
    • Above average computer skills
    • Clinical experience in ICU, ER, or medical surgical unit preferred.
  • 15 Days Ago

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RN Utilization Review FT Days
  • Detroit Medical Center Shared Services
  • Detroit, MI OTHER
  • The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients and families throughout Michigan and beyond. A premier healthcare resource, our mission is to help p...
  • Just Posted

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Lead Case Manager, Utilization Review
  • UHS
  • AUBURN HILLS, MI FULL_TIME
  • Responsibilities Quality Analyst, Full-Time, Monday - Friday.HAVENWYCK HOSPITAL (a UHS facility)Havenwyck Hospital is a 243 bed Joint Commission accredited and licensed psychiatric hospital in Auburn ...
  • 5 Days Ago

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Coordinator - Clinical Peer Review - Full Time - Wyandotte
  • Clinical Peer Review - Full Time - Wyandotte - Henry Ford Health - Careers Careers
  • Wyandotte, MI FULL_TIME
  • General Summary: With guidance and direction from the Senior Level Leadership, in collaboration with the Medical Staff Leadership Team, the Clinical Peer Review Coordinator is a registered nurse who p...
  • 21 Days Ago

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Utilization Management Case Manager
  • UHS
  • DEARBORN, MI FULL_TIME
  • Responsibilities Utilization Management Case Manager Beaumont Behavioral Health (a UHS Facility) A growing 144-bed behavioral health facility – Beaumont Behavioral Hospital provides a full continuum o...
  • 7 Days Ago

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Medical Director Utilization Management
  • BCBSM Career Section
  • Detroit, MI FULL_TIME
  • Provide clinical expertise across the enterprise for various functions. Responsible for corporate and medical policy interpretation, recommendation, and review within recognized areas of responsibilit...
  • 1 Month Ago

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0 Utilization Review Coordinator jobs found in West Bloomfield, MI area

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Scheduling Coordinator
  • IEP MSO Management, LLC
  • Farmington Hills, MI
  • Scheduling Coordinator We are Independent Emergency Physicians, or IEP, a local, physician-owned multi-specialty practic...
  • 4/19/2024 12:00:00 AM

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Operations Quality and Continuous Improvement Supervisor
  • CHEP
  • Livonia, MI
  • CHEP helps move more goods to more people, in more places than any other organization on earth via our 300 million palle...
  • 4/19/2024 12:00:00 AM

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ITS Traffic Engineer
  • AtkinsRéalis
  • Novi, MI
  • Why join us? We are hiring! AtkinsRéalis seeks an Intelligent Transportation Systems (ITS)/Traffic Engineer to join our ...
  • 4/18/2024 12:00:00 AM

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Administrative Specialist
  • Stern Law, PLLC
  • Novi, MI
  • Job Description Job Description We are seeking an Administrative Specialist to join our team! You will perform clerical ...
  • 4/18/2024 12:00:00 AM

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MDS Coordinator
  • Regency at Troy
  • Troy, MI
  • Are you an experienced MDS nurse interested in the next step? The MDS Coordinator provides oversight of the RAI process ...
  • 4/18/2024 12:00:00 AM

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Behavioral Healthcare Coordinator
  • Oakland Community Health Network
  • Pontiac, MI
  • Job Description Job Description Job Summary The Behavioral Healthcare Coordinator assists the public in a warm and welco...
  • 4/17/2024 12:00:00 AM

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Utilization Review Coordinator
  • TheraMatrix
  • Pontiac, MI
  • Job Description Job Description Duties and Responsibilities: Initial authorizations of outpatient physical therapy servi...
  • 4/16/2024 12:00:00 AM

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Project Administrator
  • Henry Yandt Construction
  • Bloomfield Hills, MI
  • Job Description Job Description Henry Yandt Construction is a full-service Construction Firm specializing in preconstruc...
  • 4/15/2024 12:00:00 AM

West Bloomfield is sometimes referred to by its residents as the "lake township of Oakland County", being heavily dotted with small and medium-sized lakes. Cass Lake, the largest lake in the county, is in part of West Bloomfield, and Pine Lake, which has a private country club on its shore, is only a few miles away from Cass and lies completely within West Bloomfield. In addition, directly west of Pine Lake is Orchard Lake, which also has a private country club on its shore. Orchard Lake is surrounded by the city of Orchard Lake Village. Several smaller lakes are scattered around these larger...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$81,352 to $100,774
West Bloomfield, Michigan area prices
were up 1.2% 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