Utilization Review Coordinator jobs in Delaware
Utilization Review Coordinator 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 Coordinator 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 Coordinator consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Registered Nurse(RN). The Utilization Review Coordinator contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. To be a Utilization Review Coordinator typically requires 4 to 7 years of related experience. (Copyright 2024 Salary.com)
Recently Added Utilization Review Coordinator jobs
Utilization Management Coordinator - Per Diem
- Dover Behavioral Health System
-
Dover, DE
PER_DIEM
-
Responsibilities:Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units for adolescents and adults and offers inpatient acute care, partial hospitalization, and intensive outpatient programs. On average, over 10,000 patients receive care from our compassionate health care team each year at Dover Behavioral Health System. This opportunity offers working at a hospital known for its outstanding patient satisfaction, including ranking 6th for highest patient satisfaction in 2020 compared to over 200 psychiatric hospitals. We attribute this success to our talented and dedicated staff. We are the best at what we do!
Dover Behavioral Health system is seeking qualified candidates for our Utilization Management Coordinator position. In this role, you will proactively monitor utilization of continuum services and optimize reimbursement.
Responsibilities will include:- Conduct admission reviews working with Assessment and Referral Services to stay abreast of admissions.
- Conduct concurrent and extended stay reviews on appropriate day and/or specified time.
- Prepare and submit appeals to third party payors, effectively coordinating collection of all pertinent data to support the hospital and patient’s position.
- Call/fax discharge information to insurance companies within 24 hours of discharge to ensure the facility is paid for the hospital stay.
- Maintain and update logs of review and maintain other appropriate records of the Utilization Review department.
- Communicate pertinent third party payors issues to doctor and treatment team.
- Attend daily treatment team meetings to discuss acuity issues, third party payors needs and gather information for reviews.
- Work independently in gathering information for reviews from the patient record, taking the initiative to seek information from members of the treatment team.
- Understand and communicate insurance information to team members, including benefits and levels of care offered.
- Perform internal utilization reviews as indicated.
- Identify, document, and report any and all instances of adult or child abuse and neglect to the appropriate parties including a member of management, the police, and state agencies
Qualifications:Minimum:- MSW or MS in a recognized mental health field or Registered Nurse
- One (1) year experience in case management and/or hospital experience
Preferred:- One (1) year experience as a Utilization Management Coordinator at a long-term care facility
Benefits:- Tuition Assistance
- Loan Forgiveness
- Orientation (Could earn 20 CEUs) * Career development opportunities across UHS and its 300 locations
- Diverse programming to expand your experience and energize your career HealthStream online learning catalogue with plenty of free CEU courses
- Competitive Compensation & Generous Paid Time Off
- Excellent Medical, Dental, Vision and Prescription Drug Plans
- 401(K) with company match and discounted stock plan
- SoFi Student Loan Refinancing Program
About our parent company Universal Health Services (UHS):One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, our annual revenues were $10.77 billion in 2018. In 2020, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; in 2019, ranked #293 on the Fortune 500; and in 2017, listed #275 in Forbes inaugural ranking of America’s Top 500 Public Companies. Headquartered in King of Prussia, PA, UHS has more than 87,000 employees and through its subsidiaries operates 26 acute care hospitals, 327 behavioral health facilities, 40 outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 37 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.
EEO StatementAll 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.
NoticeAt UHS and all subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates with matching skillset and experience with the best possible career at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail etc. If you feel suspicious of a job posting or job-related email, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449 - 25 Days Ago
Utilization Management Coordinator - Full-Time
- Universal Health Services, Inc.
-
Dover, DE
FULL_TIME
- Responsibilities Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units fo...
- 30 Days Ago
Utilization Management Coordinator - Full-Time
- UHS
-
DOVER, DE
FULL_TIME
- Responsibilities Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units fo...
- 1 Month Ago
Utilization Management Coordinator - Full-Time
- Dover Behavioral Health System
-
Dover, DE
FULL_TIME
- Dover Behavioral Health System is a 104-bed, acute care psychiatric hospital located in the beautiful Dover, Delaware area. Dover Behavioral Health System features individual units for adolescents and...
- 1 Month Ago
Utilization Management Plan Oversight Manager,
- AmeriHealth Caritas Health Plan
-
Newark, DE
FULL_TIME
- Your career starts now. We are looking for the next generation of health care leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities....
- 24 Days Ago
KYC Review Analyst- Ops
- City National Bank
-
Newark, DE
FULL_TIME
- KYC REVIEW ANALYST- OPS WHAT IS THE OPPORTUNITY?Conduct Enhanced Due Diligence background investigations for commercial loan borrowers in adherence with credit policy and compliance with BSA and USA P...
- 16 Days Ago
Utilization Review Coordinator jobs at Popular Companies
Utilization Review Coordinator (RN)
- Hiring Now!
-
Fresno, CA
- Overview:*All positions are located in Fresno/Clovis CA* *Up to $25K in bonus incentives (sign-on and relocation)* Oppor...
- 6/1/2024 12:00:00 AM
Utilization Coordinator
- Tenderheart Health Outcomes
-
Austin, TX
- Job Description Job Description For nearly two decades, TenderHeart (formerly known as Longhorn Health Solutions) has be...
- 6/1/2024 12:00:00 AM
Utility Supervisor
- City of Port Orchard Washington
-
Port Orchard, WA
- This position plans, organizes, directs, and manages the Citys water, sanitary sewer, and stormwater utilities; administ...
- 6/1/2024 12:00:00 AM
Utilization Review Coordinator (RN)
- Community Health System - CA
-
Fresno, CA
- Overview: *All positions are located in Fresno/Clovis CA* *Up to $25K in bonus incentives (sign-on and relocation)* Oppo...
- 5/31/2024 12:00:00 AM
Utility Supervisor
- StarPlus Energy
-
Kokomo, IN
- Company Overview: STARPLUS ENERGY LLC is an electrifying joint venture between Samsung and Stellantis. With a focus on i...
- 5/30/2024 12:00:00 AM
Utilization Review Coordinator / Case Management / PRN
- Christus Health
-
Santa fe, NM
- Description POSITION SUMMARY: Registered Nurse uses approved screening criteria (MCG®/CMS Inpatient List) to determine t...
- 5/29/2024 12:00:00 AM
Utilization Coordinator
- Tenderheart Health Outcomes
-
Albany, NY
- Job Description Job Description For nearly two decades, TenderHeart (formerly known as Longhorn Health Solutions) has be...
- 5/29/2024 12:00:00 AM
Utilization Review Coordinator (RN)
- Community Health System - CA
-
Fresno, CA
- Overview: *All positions are located in Fresno/Clovis CA* *Up to $25K in bonus incentives (sign-on and relocation)* Oppo...
- 5/21/2024 12:00:00 AM
About Delaware
Delaware is 96 miles (154 km) long and ranges from 9 miles (14 km) to 35 miles (56 km) across, totaling 1,954 square miles (5,060 km2), making it the second-smallest state in the United States after Rhode Island. Delaware is bounded to the north by Pennsylvania; to the east by the Delaware River, Delaware Bay, New Jersey and the Atlantic Ocean; and to the west and south by Maryland. Small portions of Delaware are also situated on the eastern side of the Delaware River sharing land boundaries with New Jersey. The state of Delaware, together with the Eastern Shore counties of Maryland and two co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Utilization Review Coordinator jobs
$82,021 to $101,602
Most Popular Cities in Delaware for Utilization Review Coordinator Jobs
What does an Utilization Review Coordinator do?
Utilization Review Coordinator in Long Beach, CA
The Utilization Review Coordinator contributes to moderately complex aspects of a project.
January 05, 2020
Utilization Review Coordinator in Gary, IN
Candidates for this role must have a good understanding of medical terminologies, and stay tuned with latest developments in the field; they should possess knowledge of reviews such as MAC, KEPRO, and RAC; strong observing skills and the ability to monitor safety plans are also needed.
December 29, 2019
Utilization Review Coordinator in Chicago, IL
Including requirements, responsibilities, statistics, industries, similar jobs and job openings for Utilization Review Coordinator.
December 30, 2019