Utilization Review Specialist
3 weeks ago
The UR Specialist reviews and monitors patients utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures.
Performs concurrent and
retrospective reviews on all patients. Monitors level and quality of care.
Responsible for the
proactive management of patients with the objective of improving quality
outcomes and decreasing costs.
Evaluates and provides
feedback to treating physicians regarding a patients discharge plans and
available covered services, including identifying alternative levels of
care that may be covered.
Monitors all utilization
reports to assure compliance with reporting and turnaround times.
Addresses care issues with
the Director of Clinical Services and Chief Medical Officer/Medical
Director as appropriate.
Coordinates an
interdisciplinary approach to support continuity of care.
Provides utilization
management, transfer coordination, discharge planning, and issuance of all
appropriate authorization for covered services as needed.
Identifies and recommends
opportunities for cost savings and improving the quality of care across
the continuum.
Clarifies health plan
medical benefits, policies and procedures for members, physicians, staff,
contract providers, and outside agencies.
Requirements
Bachelor's degree in Social Work
or related field required.
Clinical Licensure in the
State of Nevada preferred, no required
Knowledge of medical
terminology, medical records, and appropriate medical coding system.
Working knowledge with
software and/or equipment (Microsoft Office applications including
Outlook, Word, Excel and PowerPoint).
Maintains confidentiality
of patients at all times.
We proudly offer the following benefits available first of the month following just one month of employment:
Competitive rates
Flexible schedules
Tuition reimbursement
Comprehensive package of
benefits to include:
Medical
Dental
Vision
Life, Pet, Identity Theft
Insurance
401k
Generous paid time off
Short Term and Long Term
Disability
#J-18808-Ljbffr
-
Utilization Review Specialist
4 weeks ago
Reno, United States Reno Behavioral Healthcare Hospital Full timeThe UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. Performs concurrent and retrospective reviews on...
-
Utilization Review Specialist
7 days ago
Reno, United States Reno Behavioral Healthcare Hospital Full timeThe UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. + Performs concurrent and retrospective reviews on...
-
Utilization Review Specialist
3 weeks ago
Reno, United States Renobehavioral Full timeThe UR Specialist reviews and monitors patients’ utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. Performs concurrent and retrospective reviews on...
-
Utilization Review Specialist
2 weeks ago
Reno, United States Reno Behavioral Healthcare Hospital Full timeJob DescriptionJob DescriptionThe UR Specialist reviews and monitors patients’ utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures.Performs concurrent...
-
Utilization Review Specialist
3 weeks ago
Reno, Nevada, United States Reno Behavioral Healthcare Hospital Full timeThe UR Specialist reviews and monitors patients’ utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures. Performs concurrent and retrospective...
-
Director of Utility Services
6 days ago
Reno, United States City of Reno Full timeClassification Description Summary Under general administrative direction, plans, directs, manages, and oversees the activities and operations of the Utility Services Department, including planning, directing, and reviewing the activities of the department; provides professional and technical staff assistance; represents the City on water supply, sewer,...
-
Inventory Specialist
2 days ago
Reno, United States Westinghouse Electric Company Full timeSupports Plant operations, by ensuring critical spare parts and services are purchased and delivered on time, in an efficient manner. Primary Duties: Follows all procedures, in the Safe Manual procedures. Reviews purchase requisitions for accuracy, i Inventory, Specialist, Manufacturing, Retail, Support, Shipping
-
Program Specialist
1 day ago
Reno, United States Amtec Human Resources Full timeSUMMARY: The Program Specialist acts as a liaison between members and dealers for the Auto buying program. This role will be responsible for gathering information, researching, communicating and educating all parties on the guidelines of the program. They will also ensure incoming and outgoing calls are processed accurately and in a timely manner with...
-
Customer Service Specialist
5 days ago
Reno, United States Amtec Inc. Full timeCustomer Service SpecialistReno, NV 89502, United StatesESSENTIAL DUTIES AND RESPONSIBILITIES:Program Specialists will interact with Members, Dealers (including General Managers and Principals), Sales team, and various internal departments via phone and email using appropriate business acumen. The Program Specialist must demonstrate the ability to remain...
-
Customer Service Specialist
5 days ago
Reno, United States Amtec Inc. Full timeCustomer Service SpecialistReno, NV 89502, United StatesESSENTIAL DUTIES AND RESPONSIBILITIES:Program Specialists will interact with Members, Dealers (including General Managers and Principals), Sales team, and various internal departments via phone and email using appropriate business acumen. The Program Specialist must demonstrate the ability to remain...
-
Customer Service Specialist
3 days ago
Reno, United States Amtec, LLC Full timeCustomer Service Specialist Reno, NV 89502, United States ESSENTIAL DUTIES AND RESPONSIBILITIES: Program Specialists will interact with Members, Dealers (including General Managers and Principals), Sales team, and various internal departments via phone and email using appropriate business acumen. The Program Specialist must demonstrate the ability to remain...
-
Project Controls Specialist
7 days ago
Reno, United States Westinghouse Nuclear Full timeProject Controls Specialist - 1 Year Contract Denver, CO - Must live within a drivable distance, onsite role Are you interested in being part of an innovative team that supports Westinghouse's mission to provide clean energy solutions? At WECTEC Staffing Services, a wholly-owned subsidiary of Westinghouse Electric Company LLC, we recognize that our...
-
Court Specialist
3 weeks ago
Reno, United States CareerBuilder Full timeClassification Description Summary Under supervision, performs a wide variety of specialized clerical, technical, and administrative duties in support of the Reno Municipal Court operations and services including in the areas of records management, data entry, sentence compliance, public service counter, and courtroom support. Court Specialist I: This is the...
-
Retention Specialist
3 weeks ago
Reno, United States Nevada Corporate Headquarters Full timeRetention Specialist Nevada Corporate Headquarters, Inc. (NCH) has been launching businesses and careers since 1989! We focus on inspiring our employees to provide an excellent customer experience that assists our clients through every step of establishing a successful business. We promote an environment that is fun, energetic, and supportive! Our growing...
-
Retention Specialist
3 weeks ago
Reno, United States Nevada Corporate Headquarters Full timeJob DescriptionJob DescriptionSalary: $15 an Hour + Commission + BonusesRetention SpecialistNevada Corporate Headquarters, Inc. (NCH) has been launching businesses and careers since 1989! We focus on inspiring our employees to provide an excellent customer experience that assists our clients through every step of establishing a successful business. We...
-
Renewals Specialist
5 days ago
Reno, United States Nevada Corporate Headquarters Full timeJob DescriptionJob DescriptionSalary: $15 an Hour + Commission + BonusesRenewals SpecialistNevada Corporate Headquarters, Inc. (NCH) has been launching businesses and careers since 1989! We focus on inspiring our employees to provide an excellent customer experience that assists our clients through every step of establishing a successful business. We promote...
-
Retention Specialist
3 weeks ago
Reno, United States Nevada Corporate Headquarters Inc. Full timeJob DescriptionJob DescriptionRetention SpecialistNevada Corporate Headquarters, Inc. (NCH) has been launching businesses and careers since 1989! We focus on inspiring our employees to provide an excellent customer experience that assists our clients through every step of establishing a successful business. We promote an environment that is fun, energetic,...
-
Corporate Parts Support Specialist
7 days ago
Reno, United States EquipmentShare Full timeEquipmentShare is Hiring a Corporate Parts Support Specialist EquipmentShare is searching for a Corporate Parts Support Specialist for our corporate office to support our team as the department continues to grow. This is a remote position that will cover Reno, NV and the surrounding locations within the Region. EquipmentShare is seeking a Corporate Parts...
-
Retention Specialist
5 days ago
Reno, United States Nevada Corporate Headquarters Full timeJob Description Job Description Salary: $15 an Hour + Commission + BonusesRetention SpecialistNevada Corporate Headquarters, Inc. (NCH) has been launching businesses and careers since 1989! We focus on inspiring our employees to provide an excellent customer experience that assists our clients through every step of establishing a successful business. We...
-
Contracts Specialist
21 hours ago
Reno, United States Threshold Brands Full timeJob DescriptionJob DescriptionSalary: $23 - $25.00Founded in 1979, Pestmaster Services has grown into a nationally-recognized pest management company specializing in government contract services using an integrated pest management (IPM) approach. Today, we are the 2nd largest provider of pest control services to the Federal Government and utilizing our...