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)
Summary of Work
The Utilization Review Nurse exists to analyze medical information and proposed treatment plans submitted by providers to determine medical necessity and appropriateness of procedures and services. This position ensures the utilization review process is compliant with WSI administrative laws and establishes professional rapport with providers and WSI staff. Additional duties include, but are not limited to:
Minimum Qualifications
Preferred Qualifications
About Team ND
"Far and away the best prize life offers is the chance to work hard at work worth doing." - Theodore Roosevelt
More than 7,500 talented, hard-working people across sixty-three agencies have come together as Team North Dakota. At Team ND, we are driven to succeed through gratitude, humility, curiosity and courage. Our purpose is to empower people, improve lives, and inspire success. Join us in being legendary.
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485 Application Procedures
Apply online and upload the following information: cover letter (addressed to Human Resources), resume, references, and copy of college transcripts (if applicable). All application materials must be received by the closing date to be considered for the open position. Background checks will be conducted.
WSI staff will score all applications based on a 100-point scoring and rating system. Applications should include information that directly addresses how the applicant meets the minimum qualifications and a summary of work. It is very important to be thorough and detailed in the application materials. Incomplete sections in the application will not be given credit.
Applicants with disabilities should contact Denise Osmond at 701-328-3849 in advance of applying to discuss any special provisions needed for applying or interviewing.
If you are experiencing technical difficulties with the Application Process or uploading attachments, please contact recruiter@nd.gov or 701-328-3290.
ND Relay Number 1-800-366-6888.
Equal Opportunity Employer
The State of North Dakota and this hiring agency do not discriminate on the basis of race, color, national origin, sex (including sexual orientation and gender identity), genetics, religion, age or disability in employment or the provisions of services and complies with the provisions of the North Dakota Human Rights Act.
As an employer, the State of North Dakota prohibits smoking in all places of state employment in accordance with N.D.C.C. Sect. 23-12-10.