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Cord, Quality/PI, Utilization Review Coordinator

2 months ago

Lakewood, United States University Of California Irvine Full time
Job Summary

We are seeking a highly skilled Utilization Review Coordinator to join our team at the University of California, Irvine. As a key member of our Case Management department, you will play a critical role in ensuring the effective utilization of hospital resources and promoting efficient patient throughput.

Responsibilities
  • Provide system support services for the Case Management Staff, assisting the Director of Case Management with daily operations and performance improvement initiatives.
  • Manage the Coordination of Benefits (COB) and assist hospital departments with billing-related matters.
  • Ensure compliance with state and federal regulations, as well as The Joint Commission (TJC) accreditation standards and Tenet policy.
  • Develop and implement education programs for facility staff on case management best practices.
Requirements
  • Excellent written and verbal communication skills in English.
  • Ability to maintain a work pace appropriate to the workload and establish effective working relationships across the Health System.
  • Demonstrated organizational skills, critical thinking, and problem-solving abilities.
  • Computer literacy and ability to review medical charts and verify services rendered.
Preferred Qualifications
  • Knowledge of University and medical center organizations, policies, procedures, and forms.
Working Conditions

The University of California, Irvine is committed to providing a safe and healthy work environment. All applicants who accept an offer of employment must comply with the following conditions:

  • Background Check and Live Scan.
  • Legal Right to Work in the United States.
  • Vaccination Policies.
  • Smoking and Tobacco Policy.
  • Drug Free Environment.

Please note that additional conditions may apply, dependent upon business unit or job-specific requirements.