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)
Utilization Management Specialist - AdventHealth Shawnee Mission
All the benefits and perks you need for you and your family:
Our promise to you:
Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.
Schedule: Monday – Friday
Shift: 40 hours a week; Days
Location: AdventHealth Shawnee Mission
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The community you’ll be caring for:
At AdventHealth Shawnee Mission, formerly Shawnee Mission Medical Center, you're more than just a number on a chart. You're a whole person, who functions best when physically, emotionally, and spiritually fit. Find whole-person care, dedicated teams and staff, and a wide variety of medical services, all at our hospital in Shawnee Mission, Kansas.
The role you’ll contribute:
The UM Specialist will serve as the first point of escalation for payors requiring assistance in gaining additional or missing information to support authorization. The UM Specialist will be responsible for ensuring procurement of authorization upon admission and discharge as well as, accuracy of authorization information. The UM Specialist will ensure timely escalation of barriers to authorization requiring clinical expertise and assist in coordination of Peer-to-Peer discussions with the payor.
The value you’ll bring to the team:
The expertise and experiences you’ll need to succeed:
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0 Utilization Review Technician jobs found in Lenexa, KS area