Utilization Review Manager - Home Care jobs in Oregon
Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Recently Added Utilization Review Manager - Home Care jobs
Case Manager/Utilization Review/Discharge Coord
- Asante
-
Medford, OR
FULL_TIME
-
Additional Position Details: FTE: 1.000000 | Full Time | 1st Shift - Days | Will split time between the Behavioral Health Unit (0.3FTE) and Psychiatrics Care Unit (0.7FTE)
Salary is based on qualifications and years of relevant experience. Starting rate is $45.26/hr with a mid-range of $56.58/hr.
Position Summary
The role of Case Manager/Utilization Review/Discharge Coordinator requires carrying out the following key elements of case management for their assigned department: (1) admissions coordination and marketing, (2) internal case management: IRF-PAI data collection and coordination, utilization review and insurance authorization, and (3) discharge planning and coordination. Details on these responsibilities include:- Admissions Coordination: Screens referred patients for appropriateness of admissions and coordinates the admissions or denial process in collaboration with the leadership.
- Case Management: Continuously reviews and coordinates length of stay according to PCU criteria, insurance status, and other resource utilization criteria. Works collaboratively with other team members in balancing length of stay and optimum outcome goals.
- Utilization Review: Conducts utilization review, evaluates clinical information, and communicates findings to payors within the framework of contractual and government regulations.
- Discharge Planning: Coordinate all aspects of the discharge process in collaboration with other team members, including working with downstream providers, insurers, and community resources.
- Bachelor's in Nursing (BSN) or allied health field, preferred.
- Minimum of 2 years progressive nursing experience in an acute care setting preferably within discharge, utilization, and/or case management - or the equivalent combination of education and/or experience, is required.
- Registered Nurse (RN) licensed by the Oregon State Board of Nursing required upon start
- CCM: Certified Case Manager preferred.
- Progressive nursing pay - including earning more with a preferred department-designated specialty certification and/or your preferred degree!
- Comprehensive Total Rewards package including medical, dental, vision, wellness; retirement plan with up to a 6% employer contribution; and a generous paid time off policy that increases with years of service
- Tuition Reimbursement Program
Asante is more than a great hospital system in an amazing location. We are a community of passionate providers and service-focused caregivers who collaborate to deliver amazing patient outcomes; a place where titles don't matter as much as your creativity, drive, and passion. Our culture, values and people create an environment of sustained medical excellence. For more on our story and award-winning health care, click HERE.
More About Asante and Southern Oregon
Asante is a locally-managed, nationally recognized top 15 health system. We are located in beautiful Southern Oregon and are the largest healthcare provider in nine counties. We provide comprehensive medical care to more than 580,000 people throughout southern Oregon and northern California. Our facilities employ over 5000 people and include Asante Ashland Community Hospital in Ashland, Asante Rogue Regional Medical Center in Medford, Asante Three Rivers Medical Center in Grants Pass, Asante Physician Partners, and additional healthcare partnerships throughout the region.
At Asante We Believe That We Are Defined By Our Values - The Traits That Guide Us As We Serve Patients And The Community
Excellence - Respect - Honesty - Service - Teamwork
Asante is an equal opportunity employer. We are committed to employ and advance in employment women, minorities, qualified individuals with disabilities and protected veterans. - 2 Days Ago
Case Manager - Utilization Review - Surgery Specialist
- McKenzie Willamette
-
Springfield, OR
FULL_TIME
- Hourly Base Rate: $32.15 - $48.05 Shift: Day Shift Hours Per Week: 40-hours Date Posted: 3/22/2024 Job Summary: Analyzes patient records to determine legitimacy of admission, treatment, and length of ...
- 20 Days Ago
Utilization Review RN
- Asante
-
Medford, OR
FULL_TIME
- Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PMWhy AsanteAsante is more than a great hospital system in an amazing location. We are a community of passionate p...
- 11 Days Ago
Utilization Review RN
- Asante Health System
-
Grants Pass, OR
FULL_TIME
- Utilization Review RN Additional Position Details: FTE: 0.500000 | Part Time | Primarily Mon - Fri / 8AM - 5PM Why Asante Asante is more than a great hospital system in an amazing location. We are a c...
- 14 Days Ago
Utilization Review/RN - Remote
- Integrated Resources, Inc ( IRI )
-
Corvallis, OR
CONTRACTOR
- Job Name: Utilization Review/RN - remote Facility Address: 815 NW 9th St Corvallis, OR 97330 Job Description: JOB SUMMARY/PURPOSE Reviews, assesses, and evaluates clinical information used to support ...
- 14 Days Ago
Utilization Review RN
- Asante Health System
-
Medford, OR
FULL_TIME
- Utilization Review RN Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM Why Asante Asante is more than a great hospital system in an amazing location. We are a c...
- 21 Days Ago
Utilization Review Manager - Home Care jobs at Popular Companies
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- Leprino Foods
-
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Director Utilization Management
- Heritage Valley Health System, Inc.
-
Beaver, PA
- Department: Utilization Review. Work Hours: Primarily Monday through Friday, extended hours as needed to support organiz...
- 6/9/2024 12:00:00 AM
Supervisor, Utilization Management
- Centene Corporation
-
Tallahassee, FL
- You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Managem...
- 6/9/2024 12:00:00 AM
Utilization Management Specialist
- Blue Cross and Blue Shield Association
-
Meridian, ID
- Our Utilization Management Rep will coordinate and manage incoming and outgoing correspondence to include referrals, pri...
- 6/9/2024 12:00:00 AM
Director of Utilization Management
- Oceans Healthcare
-
Jackson, MS
- Description The Director Utilization Management is responsible for oversight and management of all utilization review/ca...
- 6/8/2024 12:00:00 AM
Manager, Utilization Management
- Hiring Now!
-
New York, NY
- Creates and upholds policies and procedures for coverage determinations. Serves as subject matter expert for Medicare co...
- 6/8/2024 12:00:00 AM
Director Utilization Management
- Heritage Valley Health System
-
Beaver, PA
- Department: Utilization Review Work Hours: Primarily Monday through Friday, extended hours as needed to support organiza...
- 6/7/2024 12:00:00 AM
About Oregon
Oregon (/ˈɒrɪɡən/ (listen) ORR-ih-gən) is a state in the Pacific Northwest region on the West Coast of the United States. The Columbia River delineates much of Oregon's northern boundary with Washington, while the Snake River delineates much of its eastern boundary with Idaho. The parallel 42° north delineates the southern boundary with California and Nevada. Oregon is one of only four states of the continental United States to have a coastline on the Pacific Ocean.
Oregon was inhabited by many indigenous tribes before Western traders, explorers, and settlers arrived. An autonomous government ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Manager - Home Care jobs
$77,807 to $99,192