Utilization Review Coordinator
Universal Hospital Services
Responsibilities The Psychiatric Institute of Washington is a 152-bed facility with inpatient, outpatient and partial hospitalization programs. Excellence in behavioral health programs for children, adolescents and adults has been the mission of the institute since it opened nearly 50 years ago. As the first and only freestanding psychiatric care facility in Washington, DC, our team is known for providing innovative treatment and care. We strive for excellence, never losing sight of providing patients with hope – hope that although their stay is relatively brief, they may find their way to a brighter future. Tracks new admissions or transfers to assigned area and is responsible for knowing and following through with certification requirements from admission through discharge. Serves as liaison to on-site external reviewers. Uses Midas for recording reviews and tracking denials. Adds to Midas databases as needed. Teaches staff to document medical necessity through in‑services or individual meetings. Monitors quality of records and notifies staff and program director of problems. Available to program director to develop plan for improvement as needed. Supports and guides treatment planning as needed. Continues to bring to staff awareness the need for documentation to flow from and correlate with treatment plan. Informs department director of changes in managed care companies. Maintains awareness of unique status to propose out‑of‑plan benefits or to open the door to increase hospital’s opportunity to provide services to a larger group. Works appropriately and professionally with all staff and demonstrates a supportive attitude toward the goals of the hospital. Makes recommendations for the hospital based on identified trends. Arranges schedule in consideration of needs of the department, participates in arranging coverage for planned absences and demonstrates a supportive attitude toward the goals of the department. Performs other job related duties as assigned. Benefit Highlights Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan UHS employee discounted stock option plan Tuition Reimbursement and Student Loan Repay Program Employee Assistant Program (EAP) Life Insurance and Disability Insurances Flexible Spending Account Pre‑tax Metro SmartTrip Benefits Career development opportunities within UHS and its 300+ Subsidiaries! Qualifications Bachelor’s degree in applicable field of study required Six months psychiatric utilization review either for hospital or external review organization preferred. Candidates must meet the company’s hiring criteria to include a pre‑employment verifications, background investigation and drug test. COVID Requirements PIW requires its staff to be fully vaccinated against COVID‑19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated. E‑VERIFY Statement PIW participates in E‑Verify. We will provide the Social Security Administration, and if necessary, the Department of Homeland Security, with information from each new employee’s Form I‑9 to confirm work authorization. Please note that we do not use this information to pre‑screen job applicants. EEO Statement All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success. #J-18808-Ljbffr
$18 - $20 per hour
...Utilization Review Coordinator PRIMARY PURPOSE OF THE ROLE: To provide excellent customer service and internal support to an assigned team. ARE YOU AN IDEAL CANDIDATE? Ideal candidates will thrive in a collaborative team environment, show motivation and drive in their...SuggestedWork at officeFlexible hours- ...admission through discharge. Serves as liaison to on-site external reviewers. Uses Midas for recording reviews and tracking denials. Adds... ...in applicable field of study required. Six months psychiatric utilization review either for hospital or external review organization...SuggestedLocal areaFlexible hours
$18 - $20 per hour
...Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator PRIMARY PURPOSE: To assign utilization review requests; to verify and enter data in appropriate system(s); and to...SuggestedWork at officeLocal areaFlexible hours- Comagine Health is seeking a Clinical Utilization Review Nurse (RN) to assess medical necessity and quality of healthcare services. This full-time, remote position will be responsible for conducting utilization management reviews and ensuring compliance with clinical criteria...SuggestedRemote jobFull time
- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote... ...Prior Authorization Review to join our Utilization Management team. In this role, you will... ...ensure members receive authorized care Coordinates as appropriate with healthcare...SuggestedContract workRemote work
- A leading medical review company in Washington is seeking a Utilization Management Nurse Reviewer. The role involves assessing medical necessity, reviewing patient records, and collaborating with healthcare providers to optimize care. Candidates must have a valid nursing...Remote job
- ...The Supervision Of The Nurse Manager/Clinical Coordinator. The Registered Nurse (Rn) Assesses, Plans,... ...Expectations For Customer Service, Teamwork, Resource Utilization, And Staff And Self Development As Outlined In Performance Review. Performs Other Duties As Assigned Or...Temporary workFlexible hours
$32.02 per hour
...position type and/or level. Job Summary The Coding Coordinator monitors operations, functions, workflow, and... ...documentation. Assists in the development of materials utilized in educational activities. Reviews and stays abreast of new regulations and coding...Work experience placementImmediate startRemote work- ...MDS Coordinator - Full-time Admiral Health & Rehab is under new managment and is now a Vierra... .... MDS Coordinator Assigned Tasks Utilizes the current RAI Manual as a resource... ...base. Confirms transmission files by review and printing of initial and final validation...Full timeReliefWork at officeLocal areaImmediate start
- ...individual circumstances. The Intake Coordinator is responsible for overseeing the... ...are not limited to, achieving program utilization goals and objectives, conducting intake... ...regulations, policies, and procedures. Work is reviewed and Supervised by Admissions or Program...Full time
- ...scheduling options Responsibilities Position Summary: The Therapy Coordinator (TC) oversees the rehabilitation department to ensure... ...Participate in interdisciplinary meetings including utilization review, quality assurance, resident care conferences, admissions,...Contract workRelocation packageFlexible hours
$120.7k - $238.22k
About the Job Director of Utilization Management (UM) provides strategic and operational leadership... ...prior authorization, concurrent review, and retrospective review to ensure... ...seamless transitions between UM and care coordination functions. Partners with pharmacy leadership...$20.57 - $36.27 per hour
...Health is looking for a Behavioral Health Coordinator for the Care coordination and case... ...as to insurance companies for clinical review for authorization. Primary Duties Coordinate... ..., admissions, discharges, and service utilization while ensuring compliance with...Work experience placement$62k - $141k
...re looking for a detail‑oriented Travel Coordinator. Your main role will be to streamline all... ...and handle multiple tasks Ability to utilize a customer‑focused approach Possession of... ...the Resource page on our Careers site and reviewing Our Employee Benefits page. Salary at...Full timeContract workPart timeWork at officeLocal areaRemote work$21.44 - $25.48 per hour
...pertinent information to ensure optimal care coordination (medical records, test results,... ...are well prepared for their first visit. Review department schedules to ensure the appropriateness... ...of call center experience. Experience utilizing a web-based computerized system for...Hourly payFull timeWork at office$20.83 - $34.71 per hour
...facility, verify insurance eligibility, review benefits to include co-pay and deductible... .../custody issues that might arise. Coordinate vendor or other specialized equipment required... ...System Management Post case in Cerner utilizing the policy guidelines; maximize operating...For contractorsWork experience placementWork at officeImmediate startShift work$41.91 - $69.84 per hour
...assigned to the appropriate treatment area utilizing the Emergency Severity Index (ESI) tool,... ...Instructors, Clinical Educators, Shift Coordinators, Lead ED Technician, Clinical Program... ...details - practicing Stop, Think, Act and Review in order to self‑check behavior and...For contractorsWork experience placementShift work- ...Media & Technology (TMT) Legal Practice Coordinator. The TMT Legal Practice Coordinator is responsible... ...), other federal agencies, state public utility commissions as well as regulatory... ...data and filing systems. Assist in the review and electronic distribution of weekly...Work at officeLocal areaRemote workFlexible hours
$121.08k
...Union) JOB TITLE: Senior Transformation Coordinator, TWR GRADE: MGT E SALARY: $121,078.77... ...recruitment and PAC fundraising campaigns utilizing phone banks, SMS, email and other direct... ...laws. For further information, please review the Know Your Rights notice from the Department...Local areaRemote work$105k - $120k
...centers. Opportunity We are seeking a Senior Coordinator, Talent Acquisition - Business Services... ..., assessing, and onboarding talent, utilize direct recruitment strategies and agencies... ..., including creating offer letters and reviewing background check results. Enhance the...Work at officeLocal areaRemote workFlexible hoursShift work$85k - $100k
...Middle East. We are currently seeking a Litigation Practice Coordinator in our Client Value and Practice Management department,... ...based on capabilities, availability and developmental needs. Review utilization and raise productivity issues as appropriate. Review financial...Hourly payContract workLocal area$17 - $24.26 per hour
...Care Coordinator We're unique. You should be, too. We're changing lives every day. For... ...continuity of care. Schedules patients utilizing coordinated provider list (CPL), makes... ...organization's medical record system for physician review prior to PCP follow-up appointment....Hourly payFull timeWork at officeFlexible hoursWeekend workAfternoon shift$82.35k
.... The PICU Patient Care Management Team coordinates interdisciplinary patient assessment and... ...established guidelines. The department utilizes a multi‑disciplinary approach to care, utilizing... ...- practicing Stop, Think, Act and Review to self‑check behavior and performance....Permanent employmentFull timeWork experience placementShift workRotating shift$41.91 - $69.84 per hour
...being of the community at large. The Shift Coordinator, on a shift to shift basis, directs the... ...discharge and all clinical issues. Utilize multidisciplinary approach to meeting patient... ...details—practicing Stop, Think, Act and Review in order to self-check behavior and...Work experience placementShift work$55k - $65k
BCT Partners - Logistics Associate for Head Start Monitoring Reviews BCT Partners - Logistics Associate for Head Start Monitoring Reviews... ...with federal travel regulations and reviewer preferences. Coordinate with hotels, airlines, rental car and other lodging and...Daily paidFull timeContract workTemporary workPart timeFor contractorsWork experience placementSeasonal workWork at officeRemote work$124.1k - $237.2k
...to be part of something being built from the ground up. As a Program Manager supporting a team focused on Discovery analytics and review, you’ll help shape the foundation of a new program by establishing best practices, driving process improvements, and exploring how...Relocation- Solar Project Manager - Utility Scale Development This role is based in Arlington, VA. On... ...utility‑scale solar projects, including coordination within the company, contractors,... ...and schedule. Conduct annual performance reviews of direct reports. Manage project cost...Full timeFor contractorsFor subcontractorWork at officeLocal area
$89.07k - $162.8k
...In-patient Utilization Review RN In-patient Utilization Review RN experience highly preferred. Candidate must live in the DC/Baltimore... ...and mentor for UM Team. Oversees the orientation of new UR Coordinators by establishing the plan and monitoring progress in conjunction...Live in- .... This team will be responsible for: + Reviewing job descriptions to ensure consistency,... ...with internal and external standards + Utilize sourcing, recruiting, and networking tools... ...sense of ownership while successfully coordinating activities across various functional...Local areaRemote workShift work
$89.07k - $162.8k
MedStar Health is hiring a Utilization Review RN in Clinton, MD. The role involves supervising utilization review activities and collaborating with care teams to meet patient needs. Candidates should hold a Bachelor’s in Nursing with requisite clinical experience. The...
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