Utilization Review Coordinator
Universal Health Services
Job TitleThe 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 Psychiatric Institute of Washington since it opened nearly 50 years ago. As the first and only free-standing psychiatric care facility in Washington, DC, our team has a reputation 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.Essential Duties and Responsibilities: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 OffExcellent Medical, Dental, Vision, and Prescription Drug Plans401(K) with company match and discounted stock planUHS employee discounted stock option planTuition Reimbursement and Student Loan Repay ProgramEmployee Assistant Program (EAP)Life Insurance and Disability InsurancesFlexible Spending AccountPre-tax Metro SmartTrip BenefitsCareer development opportunities within UHS and its 300+ Subsidiaries!Qualifications:Bachelor's degree in applicable field of study requiredSix 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.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.
$18 - $20 per hour
...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$81.97k - $122.95k
Luminis Health Title: Utilization Review/Case Manager-Partial Hospitalization Program Department: Lanham Partial Hospitalization Reports To: Director- Clinical Director Behavioral Health Lanham Cost Center/Job Code: 41000-42002-001148 FLSA Status: Exempt Position Objective...SuggestedFull time- ...to support the Care Management Department, coordinating quality, cost-effective care for patients. The role involves clinical review, referrals, and ensuring compliance with... ...an LPN license in Maryland or DC and have utilization review experience plus diverse clinical background...Suggested
- ...Management Department. The role focuses on coordinating and promoting quality, cost‑effective care for patients. You will review cases, obtain necessary clinical information... ...system. Ideal candidates have 1-2 years of utilization review and 3-4 years of diverse clinical...Suggested
- ...Center is seeking an experienced LPN Case Manager to support the Care Management Department by coordinating quality, cost-effective care. The role requires 1-2 years utilization review experience and 3-4 years diverse clinical experience; valid Maryland/DC LPN license; you...Suggested
- Luminis Health in Lanham, MD seeks an experienced Utilization Review/Case Manager for the Partial Hospitalization Program. You will perform and monitor integrated utilization review and case referrals with clinical staff to assure appropriate patient placement. Requirements...
- Luminis Health in Lanham, MD seeks a Utilization Review/Case Manager for the Partial Hospitalization Program. The role involves coordinating utilization reviews, obtaining clinical documentation, and interfacing with managed care to ensure appropriate patient placement...Full time
- Luminis Health in Bowie, MD, is seeking a Utilization Review/Case Manager for the Partial Hospitalization Program. The role performs concurrent... ...documentation for review and optimal patient placement. In coordination with managed care and external payors, you will ensure...
- ...iMPROve Health seeks an RN Reviewer (Workers' Compensation Utilization Review) to perform independent external medical reviews remotely as an independent contractor (1099). The reviewer applies clinical expertise to evaluate cases, ensuring medical necessity and standard...For contractorsRemote work
- Comcast is seeking a Utility Coordinator to manage utility-related activities for residential solar projects from submission to final utility approval. You will serve as the primary contact between the company, utility providers, field teams, customers, and internal stakeholders...
$51.43 - $79.84 per hour
Description Utilization Review RN @ Swedish Medical Center Part time 0.7 FTE Evening Shift Fantastic benefits and compensation package offered... ...documentation based on established department standards. Coordinates education and training for staff and other health care...Part timeWork at officeLocal areaShift workAfternoon shift$2,275.3 per week
...Job Overview TLC Nursing Associates, Inc. is seeking an experienced Registered Nurse (RN) – Utilization Review to assess the medical necessity, efficiency, and appropriateness of healthcare services. This role involves reviewing patient care plans, ensuring compliance...Weekly payLocal areaShift work$2,275.3 per week
...Job Overview TLC Nursing Associates, Inc. is seeking an experienced Registered Nurse (RN) – Utilization Review to assess the medical necessity, efficiency, and appropriateness of healthcare services. This role involves reviewing patient care plans, ensuring compliance...Weekly payShift work- Providence Health and Services is seeking a part-time Utilization Review RN at Swedish Medical Center in Seattle. The role focuses on determining admission status and medical necessity, performing UR reviews, and supporting multidisciplinary teams. The UR nurse will collaborate...Part timeAfternoon shift
- 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...Contract workRemote work
$60k - $90k
...Defense Travel Lodging Coordinator(DTMO) The Position: Censeo is seeking a Project Coordinator... ...Program Analysis and Improvement Review existing DTMO lodging programs and processes... ...practices to recommend program enhancements Utilize experience in hospitality management and...Full timeWork at officeRemote workWork from homeFlexible hoursNight shift$72.5 - $85 per hour
...Job Description Job Description Senior Project Manager – Utility Capital Programs Seattle, WA Full-Time | On-Site/Client-... ...forecasts, cost reports, and earned-value analyses Review invoices, monitor project profitability, and identify potential...Full timeContract workFor subcontractor$18.4 - $29.99 per hour
...The Student Health Insurance Coordinator acts as a liaison between students, vendors, providers... ...by the university. This includes reviewing documentation provided by international... ...assisting students in identifying and utilizing alternative payment methods. Maintains...Hourly payPermanent employmentFull timeTemporary workPart timeMonday to Friday$80k - $95k
...line riser diagrams. Models in 3D, coordinating internal and external models between Engineer... ...egress requirements per NEC. Can utilize the National Electric Code to make sure... ...and sharp visual acuity for reviewing complex documents and performing detailed...Temporary workFor subcontractorWork at office- ...Director, Operations & Maintenance position leads the TotalEnergies' Utility Scale Renewable Operations team and is responsible for day-to-... ...Collaborate closely with engineering and construction teams to review and approve project design decisions impacting operational...Full timeFor contractorsFor subcontractorWork at officeWork from homeVisa sponsorshipWork visaFlexible hours2 days per week3 days per week
- ...RN Reviewer (Workers' Compensation Utilization Review) iMPROve Health is seeking an RN Reviewer (Workers' Compensation Utilization Review) to serve as an independent contractor (1099) performing independent external medical reviews remotely on an ad hoc basis. As a peer...Remote jobContract workFor contractorsWork at officeHome office
- ...that engineering teams are effectively coordinated and managed, through having a clear knowledge... ...definitely a hands-on role technical utilities skills required to train, teach and... ...Forget" emails. Carry out performance reviews with your team and ensure training is done...Flexible hoursShift work
$18.4 - $25 per hour
...Coordinator, Loading Dock Reporting to the Sr. Director, Ballpark Operations, the Coordinator... ...complying with MLB policy. May be utilized for distribution or moving heavy items... ...employment laws. For further information, please review the Know Your Rights notice from the...Hourly payTemporary workWork at officeLong distanceFlexible hoursAfternoon shift$110k - $131k
...Job Description Job Description MDS Coordinator - Registered Nurse Status: Full-time... ...is the primary point of contact for the review and coordination of patient care plans... ...following MDS processes. Manage the utilization review (UR) process. Oversee the MAR...Full timeFlexible hours$45 per hour
...On Call MDS Coordinator Looking for an On Call MDS Coordinator (MDS certified) with experience Wage... ...accurate and efficient manner. Gathers all initial utilization data and reports results at the Utilization Data review meeting. Complies with Medicare PDPM (...Hourly pay$53.2k
...innovation, and professional growth. Job Title Coordinator, Practice Management Location... ...providing an initial analysis of associate utilization to the supervising PM; and Administer... ...matters in the Litigation department; and Review and analyze data, including issue-...Temporary workWork at officeLocal areaFlexible hours$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...Hourly payWork experience placement$58.95k - $60k
...student or a student organization. The Senior Coordinator of Student Conduct, Student... ...confidentiality and student privacy. Writes and reviews decision letters for consistency, format... ...on-campus studio apartment with all utilities provided as part of the compensation package...Full timeSummer workInternshipWork at officeLocal areaNight shiftAfternoon shift3 days per week$60.7k - $76k
...Number S618 Position Title Compensation Coordinator Class Title Staff Regular or... ...compliant basis university-wide,including reviewing exception requests and annual salaryplans... ...MicrosoftExcel and other applications to do so - - Utilizing a wide range ofcomputer applications to...Work at officeLocal areaFlexible hours- ..., the National Capital Regions’ premier coordinating authority for appointing and referral management... .... Duties and Responsibilities: Utilizing the AVAYA automated Call Distribution (ACD... ...prior to scheduling appointments. Review health care delivery plans and military...Contract workTemporary workCurrently hiringWork at officeLocal areaImmediate start
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