Utilization Review Technician 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 Technician 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 Technician consults with nurses and physicians as needed. Position is non-RN. May require an associate degree or its equivalent. Typically reports to a supervisor. May require Registered Health Information Technician (RHIT). The Utilization Review Technician gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Utilization Review Technician typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
A leading acute care hospital located in eastern Massachusetts is now searching for an experienced Nurse Director Utilization Review to join their award-winning healthcare team
This not-for-profit acute care hospital is a respected healthcare facility with a long-standing history of providing a range of quality medical services to the local community. Committed to delivering quality care, this organization offers various healthcare services, including emergency care, surgical procedures, diagnostic imaging, rehabilitation, maternity care, and specialized treatments. The hospital focuses on patient well-being and remains a trusted provider in the region.
Reporting to the Senior VP Clinical Operations, the Nurse Director Utilization Review will provide leadership to the hospital case management, integrated clinical services, discharge planning, and care transitions. Responsibilities include focusing on patient throughput and placement status, chairs the Utilization Review committee, ensures timely and effective communication with stakeholders, takes an active leadership role in daily rounds, offers in-depth knowledge of Medical and Medicaid, ensures regulatory compliance, and has oversight of department budgets. The Nurse Director is supported by one Lead Case Manager and a staff of 30 Staff Case Managers.
What Makes You Awesome:
Located in eastern Massachusetts, this region is known to attract many families and professionals due to its enjoyable climate, diverse communities, and highly rated school systems.
This organization is prepared to offer a competitive compensation package including industry leading benefits and continued growth opportunities.
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0 Utilization Review Technician jobs found in Brockton, MA area