Utilization Review Technician jobs in Delaware

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)

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UTILIZATION REVIEW SPECIALST (PRN)
  • UHS
  • NEWARK, DE OTHER
  • Responsibilities

    Rockford Center is a 138-bed mental health facility located in Newark, DE, providing easy access to a full complement of inpatient and partial behavioral health programs for children and adolescentsadults, and older adults.  Rockford is the only child inpatient behavioral health facility in DE, offers an experienced and tenured senior management team, and serves New Castle County and northern Maryland.

    Visit us online: https://rockfordcenter.com/

    Rockford Center is searching for a talented and patient centric Utilization Review Specialist!

    Key Responsibilities include:

    • Completes pre-certs and concurrent reviews as assigned, on appropriate day and by the specified time.
    • Completes write-ups on new admissions and step-downs/step-ups as assigned, along with the “Change Level of Care” form when applicable.
    • Communicates with ARC to gather pre-cert information for new admissions as needed.
    • Enters authorizations into the MIDAS by the end of each business day.
    • Participates in daily treatment teams: communicates pertinent payor
      information, requests, or concerns; gathers information needed for reviews, and facilitates the signing of Medicare forms when applicable.
    • Takes initiative to independently gather additional information for reviews as needed.
    • Calls in discharge information to payor by the end of the business day following discharge, or on day of discharge as required by some payors.
    • Signs patient treatment plans.
    • Communicates to the Director of UR any unplanned or cancelled discharges, denied days, reasons given for underutilized days, and/or any payor-related problems.
    • Facilitates physician reviews promptly when a case is denied.
    • Maintains and updates appropriate records of the UR Department, including UR Worksheets and treatment team notes.

    Benefits for a Utilization Review Specialist include:

    • Challenging and rewarding work environment
    • 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
    • Career development opportunities within UHS and its 300 Subsidiaries!
    • Tuition Assistance

     

    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.


    Qualifications

    Job Requirements:

    • Education:  Master’s prepared Social Worker or Licensed Registered Nurse.

     

    • Experience: Previous experience in Behavioral Health preferred, but not required.

     

    • Additional Requirements:  CPR certification and Completion of Handle With Care training within 90 days of employment. 

     

    Physical and Mental requirements of Job:

     

    Able to stop, crouch, reach, walk, and stand for sustained periods of time; use extremities to press against something with steady force, as well as pull objects, using extremities to draw, drag, haul, or tug in a sustained motion; able to feel, grasp, and finger objects and lift them from a lower to higher position or horizontally from one position to another; express and exchange ideas via spoken or written work to convey detailed information in an audible and quick manner, able to make fine discriminations in sound and to perceive the nature of sounds with no less than a 40lb loss @Hz, 1,000 Hz and 2,000 Hz, with or without correction; able to substantially move wrist, hands and/or fingers in a repetitive motion.

     

    Must be able to exert up to 20 lbs. of force occasionally, and/or up to 10 lbs. of force frequently, and occasionally exert up to 50 lbs. of force.

     

    Visual Acuity:

     

    Visual acuity required adequate for preparing and analyzing data and figures, accounting, transcription, characters on computer terminals, reading, and visual inspections necessary.

     

    Physical Surroundings:

     

    The worker is not substantially exposed to adverse environmental conditions.

     

    Emotional or Mental Stress:

     

    Must be able to work with several distractions including light conversations.  Must be able to deal with aggressive, hostile and irrational behaviors of patients.  Must be able to respond immediately in crisis situations concerning patients and/or family members.

     

    The worker may be subjected to environmental conditions that occur inside and outside via routine travel; much work, however, occurs inside under typical hospital conditions.

     

     

    The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification.  They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills of personnel so classified.

     

     

     

     

     

    This opportunity provides the following: Challenging and rewarding work environment Growth and development opportunities within UHS and its subsidiaries Competitive Compensation UHS is a registered trademark of UHS of Delaware, Inc., the management company for Universal Health Services, Inc. and a wholly-owned subsidiary of Universal Health Services, Inc. Universal Health Services, Inc. is a holding company and operates through its subsidiaries including its management company, UHS of Delaware, Inc. All healthcare and management operations are conducted by subsidiaries of Universal Health Services, Inc. To the extent any reference to "UHS or UHS facilities" on this website including any statements, articles or other publications contained herein relates to our healthcare or management operations it is referring to Universal Health Services' subsidiaries including UHS of Delaware. Further, the terms "we," "us," "our" or "the company" in such context similarly refer to the operations of Universal Health Services' subsidiaries including UHS of Delaware. Any employment referenced in this website is not with Universal Health Services, Inc. but solely with one of its subsidiaries including but not limited to UHS of Delaware, Inc. UHS is not accepting unsolicited assistance from search firms for this employment opportunity. Please, no phone calls or emails. All resumes submitted by search firms to any employee at UHS via-email, the Internet or in any form and/or method without a valid written search agreement in place for this position will be deemed the sole property of UHS. No fee will be paid in the event the candidate is hired by UHS as a result of the referral or through other means.

  • 19 Days Ago

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RN - Utilization Review (Evenings) #41067
  • AdeIphi MedicaI Staffing®
  • Lewes, DE FULL_TIME
  • Summary:Ref #: 41067.Profession: Registered Nurse.Specialty: Utilization Review.Job Type: Full-time.Start Date: ASAP.Location: Lewes, DE.Shift Schedule: 8 hrs per day; 2:00 PM - 10:30 PM.Weekend Requi...
  • 28 Days Ago

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Case Management Coordinator - Utilization Review Specialist
  • MeadowWood Hospital
  • Castle, DE FULL_TIME
  • Education: Must have a Bachelors degree; Masters degree or RN license preferred. Assure residents meet criteria for admission, and review initial clinical information through discharge. Monitor and ma...
  • 2 Days Ago

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Plant Technician
  • Procter & Gamble | Plant Technician
  • Dover, DE OTHER
  • Are you ready to gain new skills to help run and maintain the latest production technology and equipment for the world’s biggest brands? We’re looking for team players who know how to take charge of b...
  • 21 Days Ago

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Formulation Process Analyst
  • 10000788 - Manufacturing Senior Technician
  • Newark, DE FULL_TIME
  • This is a first shift (Day) role with hours 6am-3pm M-F. Accountabilities:As a Process Analyst, you will provide analytical and process improvement support to the pharmaceutical operations in Formulat...
  • 16 Days Ago

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Utilization Management Specialist I
  • SUN Behavioral Delaware
  • Georgetown, DE FULL_TIME
  • Position Summary: Responsible for the coordination of case management strategies pursuant to the Case Management process. Assists and coordinates care of the patient from pre-hospitalization through d...
  • 7 Days Ago

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System Integration Technical Expert
  • Traxen
  • Plymouth, MI
  • We are a Plymouth, Michigan based startup, developing cutting-edge technologies for Driver Assistance and Automated Driv...
  • 4/24/2024 12:00:00 AM

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Structural Technical Expert
  • Olsson
  • San Juan, PR
  • We are Olsson, a team-based, purpose-driven engineering and design firm. Our solutions improve communities and our peopl...
  • 4/24/2024 12:00:00 AM

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Structural Technical Expert
  • Olsson Associates Inc.
  • Fort Worth, TX
  • We are Olsson, a team-based, purpose-driven engineering and design firm. Our solutions improve communities and our peopl...
  • 4/24/2024 12:00:00 AM

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Technical Expert, Electrical
  • ASARCO LLC
  • Marana, AZ
  • Technical Expert, Electrical Employee Type: Salary City: Marana State/Territory: US-AZ Positions Open: 1 Site Name: Silv...
  • 4/23/2024 12:00:00 AM

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Principal Technical Expert Consultant
  • Koniag Government Services
  • Arlington, VA
  • EHSJob ID 2415031Eagle Harbor Solutions, a Koniag Government Services company , is seeking a Principal Technical Expert ...
  • 4/23/2024 12:00:00 AM

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Technical Specialist
  • NV5
  • Lexington, KY
  • Overview: The Technical Specialist works to support the Lidar or Ortho Team on various tasking. This individual provides...
  • 4/21/2024 12:00:00 AM

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ADAS Hardware Components Technical Expert
  • Ford
  • Dearborn, MI
  • Job Description In this position... We are the movers of the world and the makers of the future. We get up every day, ro...
  • 4/21/2024 12:00:00 AM

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Technical Specialist - Chiller Technician
  • Wake County Public School System
  • Raleigh, NC
  • Overview: POSITION TITLE (Oracle title) TECHNICAL SPECIALIST WORKING TITLE Technical Specialist-Chiller Technician SCHOO...
  • 4/20/2024 12:00:00 AM

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 Technician jobs
$63,879 to $89,132

Utilization Review Technician in Little Rock, AR
Based on our compensation data, the estimated salary potential for Utilization Review Technician will increase 16 % over 5 years.
February 07, 2020
Utilization Review Technician in Fairbanks, AK
Current National Pharmacy Technician Certification (PTCB, ExCPT or NCCT) required.
February 03, 2020
Utilization Review Technician in Winston Salem, NC
When considering cost of living, this places Durham, NC as 3rd out of the 4 largest nearby metros in terms of quality of life for Utilization Review Technicians**.
January 02, 2020