Coordinator - Utilization Review Job at Lower Bucks Hospital
Overview:
Join an award-winning team of dedicated professional committed to our core values of quality, compassion and community! Lower Bucks Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Lower Bucks Hospital is an acute care, community hospital serving the Lower Bucks County region with medical, surgical, and emergency care. The hospital is part of Prime Healthcare's Pennsylvania Region. Prime Healthcare Pennsylvania Region includes Roxborough Memorial Hospital in Philadelphia, Lower Bucks Hospital in Bucks County, and Suburban Community Hospital in Montgomery County.
Prime's hospitals in Pennsylvania are certified by The Joint Commission as Primary Stroke Centers and have won multiple awards through Healthgrades and the Get With The Guidelines Quality Achievement Awards though the American Heart Association. Our hospitals offer medical, surgical, and emergency care, which includes diagnostic radiology, lab services, behavior health, heart care, rehabilitation, family medicine, wound care, and residency programs.
Through high quality medical care, educational programs, and community outreach services, our hospitals treat all members of our communities with respect and compassion. For more information, visit www.lowerbuckshosp.com.
Responsibilities:
Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings. Serves as on-going educator to all departments. Responsible for reviewing patient charts in order to assess whether the 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 and Work Experience
Required qualifications:
1. Bachelor’s degree in Medicine or Nursing or related Clinical field.
Preferred qualifications:
1. ECFMG Certification And/or Bachelor’s or higher from a US-based accredited institution in a Health and Human Services field is highly preferred.
2. Utilization Review experience is highly preferred.
3. Must meet the performance standards set forth by the Hospital/ Department at UR Coordinator position for at least 6 months.
4. 1+ year of clinical experience in acute care setting preferred.
5. Excellent written and verbal communication skills. Excellent critical thinking skills.
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
Please Note :
epokagency.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, epokagency.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.
Join an award-winning team of dedicated professional committed to our core values of quality, compassion and community! Lower Bucks Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Lower Bucks Hospital is an acute care, community hospital serving the Lower Bucks County region with medical, surgical, and emergency care. The hospital is part of Prime Healthcare's Pennsylvania Region. Prime Healthcare Pennsylvania Region includes Roxborough Memorial Hospital in Philadelphia, Lower Bucks Hospital in Bucks County, and Suburban Community Hospital in Montgomery County.
Prime's hospitals in Pennsylvania are certified by The Joint Commission as Primary Stroke Centers and have won multiple awards through Healthgrades and the Get With The Guidelines Quality Achievement Awards though the American Heart Association. Our hospitals offer medical, surgical, and emergency care, which includes diagnostic radiology, lab services, behavior health, heart care, rehabilitation, family medicine, wound care, and residency programs.
Through high quality medical care, educational programs, and community outreach services, our hospitals treat all members of our communities with respect and compassion. For more information, visit www.lowerbuckshosp.com.
Responsibilities:
Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings. Serves as on-going educator to all departments. Responsible for reviewing patient charts in order to assess whether the 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 and Work Experience
Required qualifications:
1. Bachelor’s degree in Medicine or Nursing or related Clinical field.
Preferred qualifications:
1. ECFMG Certification And/or Bachelor’s or higher from a US-based accredited institution in a Health and Human Services field is highly preferred.
2. Utilization Review experience is highly preferred.
3. Must meet the performance standards set forth by the Hospital/ Department at UR Coordinator position for at least 6 months.
4. 1+ year of clinical experience in acute care setting preferred.
5. Excellent written and verbal communication skills. Excellent critical thinking skills.
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
Please Note :
epokagency.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, epokagency.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.