Utilization Review Technician jobs in Kentucky

Utilization Review Technician 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 Technician 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 Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Case Management Specialist - Utilization Review
  • Utilization Review in Owensboro, KY - Owensboro
  • Owensboro, KY FULL_TIME
  • Summary

    Job Summary

    Facilitates cost-effective, quality patient outcomes by determining the appropriate level of care and providing guidance, education, and support to assigned patients.
     
    Job Responsibilities
    • Assessment of complete chart and knowledge of patient's medical condition, financial status, emotional needs, and support systems.
    • Conducts initial and concurrent reviews of clinical documentation for medical necessity and appropriate level of care using approved criteria within specified time frame.
    • Provides appropriate clinical information to payers as requested within specified time frame.
    • Collaborates with the Physician, Medical Director, Director, Manager, and Supervisor of Case Management on patients who are not meeting the regulatory requirements for hospitalization.
    • Delivers regulatory letters to patients as needed.
    • Provides education and acts as a resource for physicians, staff, and patients/families regarding utilization review processes.
    • Trains new case managers, students, and interns as needed.
    Qualifications
    • Associate's degree or higher in Nursing required upon hire AND
    • Bachelor's degree or higher in Nursing required within 5 years of employment in this position
    • No experience required
    • RN - Licensed as a Registered Nurse. Eligible to practice nursing in the State of Kentucky required upon hire
    Skills and Attributes
    • Requires critical thinking skills and decisive judgment.
    • Works under minimal supervision.
    • Must be able to work in a stressful environment and take appropriate action.
    Physical Demands
    • Standing: Occasionally
    • Walking: Occasionally
    • Sitting: Frequently
    • Lifting 0-25 lbs: Rarely
    • Lifting 25-75 lbs: Never
    • Lifting over 75 lbs: Never
    • Carrying 0-25 lbs: Rarely
    • Carrying 25-75 lbs: Never
    • Carrying over 75 lbs: Never
    • Pushing/Pulling 0-25 lbs: Rarely
    • Pushing/Pulling 25-75 lbs: Never
    • Pushing/Pulling over 75 lbs: Never
    • Climbing: Rarely
    • Bending/Stooping: Rarely
    • Kneeling: Rarely
    • Crouching/Crawling: Rarely
    • Reaching: Occasionally
    • Talking: Frequently
    • Hearing: Occasionally
    • Repetitive Foot/Leg Movements: Never
    • Repetitive Hand/Arm Movements: Frequently
    • Keyboard Data Entry: Frequently
    • Running: Never
    • Vision: Depth Perception: Frequently
    • Vision: Distinguish Color: Frequently
    • Vision: Seeing Far: Frequently
    • Vision: Seeing Near: Frequently
    Owensboro Health Core Commitments

    INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.

    RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.

    TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.

    INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.

    SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.

    EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.
  • 8 Days Ago

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Utilization Review Case Coordinator
  • UHS
  • LEXINGTON, KY FULL_TIME
  • Responsibilities Utilization Review Case Coordinator Opportunity:Full Time, Day Shift The Case Coordinator is responsible for managing and coordinating the treatment activities offered to the patient,...
  • 22 Days Ago

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Utilization Review Supervisor
  • BrightSpring Health Services
  • Louisville, KY FULL_TIME
  • Our Company: BrightSpring Health Services Overview: The Home Health Utilization Review Supervisor will manage and conduct Utilization Review activities to include, but not limited to, ICD-10 coding an...
  • 10 Days Ago

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Utilization Review Coordinator
  • Ramey-Estep / Re-group
  • Rush, KY FULL_TIME
  • Function:The Utilization Review Coordinator (URC) has the primary responsibility of monitoring adherence to the agency’s utilization review procedures and ensuring appropriate leveling of client needs...
  • 10 Days Ago

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Utilization Review Clinician
  • Addiction Recovery Care
  • Louisa, KY FULL_TIME
  • About Addiction Recovery CareAt Addiction Recovery Care we incorporate the best practices of clinical drug addiction treatment. We provide addiction recovery that works with a commitment to provide ho...
  • 14 Days Ago

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FT Discharge Planner/Utilization Review
  • Livingston Hospital
  • Salem, KY OTHER
  • Job Details Job Location: Livingston Hospital and Healthcare Services Inc - Salem, KY Position Type: Full Time Education Level: Associate Degree Salary Range: Undisclosed Travel Percentage: None Job S...
  • 22 Days Ago

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Tech Expert - Friction Clutch
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 3/27/2024 12:00:00 AM

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Display Application Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 3/27/2024 12:00:00 AM

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Switch Team Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 3/27/2024 12:00:00 AM

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ADAS Hardware Components Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description In this position... We are the movers of the world and the makers of the future. We get up every day, ro...
  • 3/27/2024 12:00:00 AM

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Technical Expert
  • Kelly Science, Engineering, Technology & Telecom
  • Hauppauge, NY
  • Quality / Reliability Engineer -- Hauppauge, NY - 6 to 12 Month Contract Assignment No C2C or Sponsorship available at t...
  • 3/25/2024 12:00:00 AM

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Manufacturing Technical Expert (Stamping)
  • American Honda Motor Co Inc
  • Marysville, OH
  • At Honda, The Power of Dreams drives us to create intelligent products that enhance mobility and increase the joy in peo...
  • 3/25/2024 12:00:00 AM

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System Integration Technical Expert
  • Traxen
  • Plymouth, MI
  • We are a Plymouth, Michigan based startup, developing cutting-edge technologies for Driver Assistance and Automated Driv...
  • 3/25/2024 12:00:00 AM

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Billing Technical Expert
  • Grow Therapy
  • New York, NY
  • About us: Grow Therapy is on a mission to serve as the trusted partner for therapists growing their practice, and patien...
  • 3/24/2024 12:00:00 AM

Kentucky (/kənˈtʌki/ (listen) kən-TUK-ee), officially the Commonwealth of Kentucky, is a state located in the east south-central region of the United States. Although styled as the "State of Kentucky" in the law creating it, (because in Kentucky's first constitution, the name state was used) Kentucky is one of four U.S. states constituted as a commonwealth (the others being Virginia, Pennsylvania, and Massachusetts). Originally a part of Virginia, in 1792 Kentucky became the 15th state to join the Union. Kentucky is the 37th most extensive and the 26th most populous of the 50 United States. Ke...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Technician jobs
$59,062 to $82,413

Utilization Review Technician in Little Rock, AR
Based on our compensation data, the estimated salary potential for Utilization Review Technician will increase 16 % over 5 years.
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Utilization Review Technician in Fairbanks, AK
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Utilization Review Technician in Winston Salem, NC
When considering cost of living, this places Durham, NC as 3rd out of the 4 largest nearby metros in terms of quality of life for Utilization Review Technicians**.
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