Medical Review Coordinator I - Utilization Management
Medical Review Coordinator I - Utilization Management
Employer Active
Job Alert
You will be updated with latest job alerts via email
Share
Job Alert
You will be updated with latest job alerts via email
Job Description
Overview
Department:Utilization Management
Schedule:Days MF 8am4:30pm
Facility:Prime Healthcare St. Joseph Hospital of Joliet
Location: Joliet IL 60435
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race color sex sexual orientation gender identity religion national origin age (subject to applicable law) disability military status genetic information or any other basis protected by applicable federal state or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: and completes the clinical reviews for all patient medical records while working closely with CMO (Chief Medical Officer). Actively participates in the Case management and UR meetings. Serves as ongoing educator to all departments. Responsible for reviewing patient charts in order to assess whether the clinical criteria for admission and continuation of treatment is being met; gathering data and responding to request for records from payers/fiscal intermediary etc.; gathering clinical and fiscal information and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and use sound judgment. Knowledge of Federal State and intermediary guidelines related to inpatient acute care hospitalization as well as lower levels of care for the continuity of treatment. Coordinates discharge referrals as requested by clinical staff fiscal intermediary patients and families. Performs other duties as assigned.
Qualifications
EDUCATION EXPERIENCE TRAINING
Required qualifications:
1. Master of Public Health (MPH) or postgraduation in a related health care field is required.
2. Medical Graduate Dental Graduate required.
3. Knowledge of Clinical Pathophysiology and Pharmacology required.
Preferred qualifications:
1. ECFMG Certification And/or Bachelors or higher from a USbased accredited institution in a Health and Human Services field is highly preferred.
2. Utilization Review/Case Management experience is highly preferred.
3. 1 year of clinical experience in acute care setting preferred.
4. Excellent written and verbal communication skills. Excellent critical thinking skills.
5. Excellent interpersonal skills to build effective partnering relationships with physicians nurse staff coding staff and hospital management staff.
6. Ability to work independently in a timeoriented environment.
7. Computer data entry with 10key preferred with accurate typing speed of 35 wpm preferred.
Saint Joseph Medical Center Joliet offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes but is not limited to paid time off a 401K retirement plan medical dental and vision coverage tuition reimbursement and many more voluntary benefit options. A reasonable compensation estimate for this role which includes estimated wages benefits and other forms of compensation is $32.00 to $46.35. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire in which a wide range of factors will be considered including but not limited to skillset years of applicable experience education credentials and licensure.
#LIMP2
Required Experience:
IC
Employment Type
Full-Time
