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)
It's more than a career, it's a calling
WI-SSM Health St. Mary's Hospital - MadisonWorker Type:
Job Highlights:
Department: Utilization Management
Patient Population or Ratio: N/A
Schedule: Full-time, Monday-Friday, 8:00am-4:30pm
Starting Pay: $71,198.40/annually (Offers are based on years of experience and equity for this role.)
Shift Differentials: N/A
Location: SSM Health St. Mary's Hospital - Madison, WI
At SSM Health, we believe in providing our employees with a fulfilling career. We strive to create an environment where individuals can grow both personally and professionally. Our company values diversity, innovation, and collaboration, and we are committed to making a positive impact on the communities we serve.
Joining SSM Health means becoming part of a team that is dedicated to providing exceptional patient care and making a difference in people's lives. Our employees are passionate about what they do, and their commitment to our mission is what sets us apart.
The role of the RN-Utilization Review supports our organization by ensuring patients are at the appropriate level of care - this is essential when it comes to insurance coverage for patients.
Job Summary:
Ensure payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.Job Responsibilities and Requirements:
PRIMARY RESPONSIBILITIES
EDUCATION
EXPERIENCE
REQUIRED PROFESSIONAL LICENSE AND/OR CERTIFICATIONS
State of Work Location: Illinois
State of Work Location: Missouri
State of Work Location: Oklahoma
State of Work Location: Wisconsin
Work Shift:
Day Shift (United States of America)Job Type:
Department:
SSM Health is an equal opportunity employer. SSM Health does not discriminate on the basis of race, color, religion, national origin, age, disability, sex, sexual orientation, gender identity, pregnancy, veteran status, or any other characteristic protected by applicable law. Click here to learn more.