UTILIZATION REVIEW SPECIALIST Job at Ephraim McDowell Regional Medical Center
Non-Clinical
Ephraim McDowell Regional Medical Center
01 Case Mgmt
Flex, Varied Shifts, Mon-Fri, 8am-5pm
Req # 9808
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Job SummaryUnder the general direction of the director, provides utilization review for appropriateness of admission and continued stay per guideline according to established criteria. Exhibits the F.I.R.S.T. values (Friendliness, Innovation, Respect, Service, and Trust).
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Working Conditions, Hazards and Physical EffortWorks in a typical office environment and moves throughout the Medical Center. Moderate amount of walking required. Moderate amount of stress in working with physicians. The task of this job does not involve exposure to blood, body fluids, or tissue. Must be able to lift 25 lbs. independently.
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Minimum Qualifications or EquivalentsExperience: Five years experience in an acute care setting; Previous experience in this utilization review preferred.Experience: Five years experience in an acute care setting; Previous experience in this utilization review preferred.EQUIPMENT USED/SPECIAL SKILLS REQUIRED: Proficient computer skills required. Preferred knowledge of the Meditech software or equivalent. Must be skilled in interpretation of Medicare/Medicaid regulations and third party payers regarding Medical Center services including discharge planning. Must be skilled in medical terminology an diagnosis. Utilizes communication skills with a high degree of effectiveness in working with patients, families, physicians, Medical Center Associates and review agencies.
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Licenses, Certifications, and/or RegistrationsLPN, CNA, CMA.
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