Utilization Review Case Manager

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

*Pay Range: $32/hr. to $60/hr.

Work Schedule: Monday to Friday from 8:00 a.m. to 4:30 p.m.

Responsibilities:

• Admissions: Conduct admission reviews
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews
• Payment Appeals: Prepare and submit appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well with stress and have a strong sense of compassion
• Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds
...

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

*Pay Range: $32/hr. to $60/hr.

Work Schedule: Monday to Friday from 8:00 a.m. to 4:30 p.m.

Responsibilities:

• Admissions: Conduct admission reviews
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews
• Payment Appeals: Prepare and submit appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well with stress and have a strong sense of compassion
• Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds
...

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

*Pay Range: $32/hr. to $60/hr.

Work Schedule: Monday to Friday from 8:00 a.m. to 4:30 p.m.

Responsibilities:

• Admissions: Conduct admission reviews
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews
• Payment Appeals: Prepare and submit appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well with stress and have a strong sense of compassion
• Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds
...

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

*Pay Range: $32/hr. to $60/hr.

Work Schedule: Monday to Friday from 8:00 a.m. to 4:30 p.m.

Responsibilities:

• Admissions: Conduct admission reviews
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews
• Payment Appeals: Prepare and submit appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well with stress and have a strong sense of compassion
• Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds
...

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

*Pay Range: $32/hr. to $60/hr.

Work Schedule: Monday to Friday from 8:00 a.m. to 4:30 p.m.

Responsibilities:

• Admissions: Conduct admission reviews
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews
• Payment Appeals: Prepare and submit appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well with stress and have a strong sense of compassion
• Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds
...

Work as member of multi-disciplinary treatment team reviewing patient care and treatment options for both inpatient and outpatient services. Proactively monitor and optimize reimbursement for external reviewers/third party payers.

*Pay Range: $32/hr. to $60/hr.

Responsibilities:

• Admissions: Conduct admission reviews
• Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews
• Payment Appeals: Prepare and submit appeals to third party payers
• Recordkeeping: Maintains appropriate records of the Utilization Review Department
• Training: Provide staff in-service training and education
• Maintains confidentiality of patients at all times
• Ability to cope well with stress and have a strong sense of compassion
• Sensitivity to and willingness to interact with persons of various social, cultural, economic and educational backgrounds
• Proficiency with software and/or equipment (Microsoft Office...

The Utilization Review Case Manager is responsible for working with insurance companies and managed care systems for the authorization, concurrent and retrospective review of inpatient admissions and services. This position will obtain authorization for each admitted patient. Review and monitor each step of the authorization process to proactively identify potential problems to help patients access the full range of their benefits through the utilization review process.

• Conducts admission reviews.
• Conducts concurrent and extended stay reviews.
• Prepares and submits appeals to third party payors.
• Maintains appropriate records of the Utilization Review Department.
• Performs related duties, as requested.
• Upholds the Organization's ethics and customer service standards.

*This position is on-site and NOT a remote...