Utilization Review Specialist Job at Lawrence General Hospital, Lawrence, MA

SENxS3dKQmN5MTE0cXRvRTN3NTZqeWc9
  • Lawrence General Hospital
  • Lawrence, MA

Job Description

Utilization Review Specialist Location Lawrence, MA :

The Utilization Review Specialist, under supervision and in collaboration with the Utilization Review Coordinator, Utilization Review Nurses, Physician advisor and healthcare team supports all administrative tasks/responsibilities for utilization management and revenue integrity cycle processes. Interacts directly and indirectly with internal and external providers to review and monitor members' utilization of health care services with the goal of maintaining high-quality cost-effective care. The URS works collaboratively with utilization management staff to obtain information from clinical reviews and medical records to provide the appropriate communication for authorization of medical services and procedures. The URS is an integral member of the health care team as well as the integrated care team and supports the case management/utilization review team on system-wide quality improvement/performance improvement initiatives. Perform other duties as needed and assigned by your supervisor. REQUIRED EDUCATION AND EXPERIENCE:

  • Bachelor's Degree
  • 1-2 year case management and utilization review experience in an acute care setting
  • Knowledge and understanding of medical terminology
  • Strong organizational skills
  • Flexibility and accountability
  • Demonstrated verbal, written skills
  • Interpersonal skills required
  • Critical thinking and knowledge of regulatory standards and reimbursement requirements
  • Computer skills required

Lawrence General Hospital is a private, non-profit community hospital providing the Merrimack Valley & southern New Hampshire regions with patient-centered, compassionate, and quality health care for the whole family. For over 140 years, the dedicated doctors, nurses, and staff of Lawrence General have been committed to improving the health of the people and communities we serve.

We are an Equal Opportunity Employer committed to hiring a diverse workforce.

Location: Lawrence General Hospital · Integrated Care Schedule: 40 hours, Days, Days

Job Tags

Full time,

Similar Jobs

Open Door Unlimited, Inc.

Non-Invasive Cardiologist opening near Lafayette, IN (IN604-CARD) Job at Open Door Unlimited, Inc.

Medical clinic near in Indiana is in need of a Board Certified or Board Eligible Non-Invasive Cardiologist. This is a full time, permanent, employed position. A very competitive compensation package is offered including health insurance, malpractice insurance, bonuses ...

TechHi Consultants

Environmental, Health and Safety Manager Job at TechHi Consultants

 ...systems, processes and procedures that promote a positive safety culture which results in an injury free and healthy...  ...facility EHS risk profiles. Ensure legal compliance in health and safety as well as environmental level for the site; Define, implement, control and... 

Concentra

Medical Assistant - Downtown LA Per Diem Job at Concentra

 ...Medical Assistant - Downtown LA Flexible Schedule - Evening/ Weekends/Overnight Status Per Diem The Medical Assistant is responsible for performing routine medical and testing procedures under direct supervision of the treating clinician as well as supports in... 

TNStumpff Enterprises

CDS Mail Carrier Job at TNStumpff Enterprises

 ...Now Hiring: Rural Mail Carrier (USPS CDS Route Prescott Valley, AZ) TNStumpff Enterprises, LLC Are you looking for stable, meaningful work with competitive pay and daytime hours? TNStumpff Enterprises, LLC the nations leader in Contract Delivery Service (CDS... 

Yale New Haven Health

Nurse Educator - Psych Job at Yale New Haven Health

 ...individuals and professionals, every day. The Nursing Professional Development Specialist (...  .../Veteran Responsibilities:1.Education 1.1Assesses the learning needs based...  ...requested, throughout the health system. Travel to YNHHS entities as needed to facilitate...