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Case Management/Utilization Review Coordinator

Cherokee, IA

Utilization Review Coordinator 

 

RESPONSIBLE TO: Patient Experience Manager

POSITION:

  • Benefited, Full-time
  • Monday – Friday 8am to 4:30pm-32 to 40 hours weekly

JOB SUMMARY:  

The UR Coordinator is responsible for collaborating with healthcare providers, clinical staff, and patient’s to promote quality care outcomes, and the effective use of resources. Additional duties include accurately interpreting treatment plans and medical records in accordance with current standards of care along with accurately interpreting participating Managed Care Organizations (MCOs) certification requirements.

The Utilization Review Coordinator is responsible for reviewing assigned admissions, continued stays, utilization practices and discharge planning according to approved clinically valid criteria and meeting the daily deadlines to obtain authorizations and complete other pertinent processes.

QUALIFICATIONS:

  • Required – Graduate of an accredited school of nursing,
  • Preferred – Bachelor’s degree 
  • 3 years previous experience in clinical care.
  • Preferred – Utilization Review experience.
  • Experience in patient assessment, treatment planning, CMS quality improvement guidelines, in particular experience working with Medicare/Medicaid and communication with external review organizations or comparable entities.
  • Current RN Licensure in the State of Iowa.
  • Current BLS certification.

Competitive wage and benefits offered include: paid time off, health, dental and vision insurance, life insurance, short term and long term disability, retirement program, tuition assistance, funeral leave, jury duty, flex spending, EAP, health and wellness program.

 

 

Status: Full Time

Category: Medical/Health

Occuaption: Nursing

Industry: Healthcare Services