Utilization Review Coordinator
Central Montana Medical Center
Lewistown, MTFull-timeSeen todaySeen in employer's feed today
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Requirements
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Job overview
The Utilization Review Coordinator ensures appropriate and efficient use of healthcare services and resources, conducts Medicare, Medicaid and third‑party payer utilization reviews, supports quality improvement and risk management, validates census statistics, and collaborates with physicians and interdisciplinary teams to promote accurate documentation and regulatory compliance.
Skills & qualifications
Skills
Qualifications
Full job description
Experience Required
Exp with Utilization Review, Medical Audit/Review or QI preferred
License(s) Required
Must be a graduate of an approved program for: Registered Nurse (RN), Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT) or Licensed Practical Nurse (LPN)
Compensation
$ / yearly
Hours Per Week
40
Number Of Positions
1
Shift
1
Job Description
The Utilization Review Coordinator is responsible for ensuring the appropriate and efficient utilization of healthcare services and resources in accordance with Medical Center policies, regulatory requirements, and payer guidelines. This position conducts Medicare, Medicaid, and third-party payer utilization reviews; supports quality improvement, risk management, and discharge planning activities; validates census statistics; and collaborates with physicians, nursing staff, and interdisciplinary teams to promote accurate documentation, regulatory compliance, and high-quality patient care. The coordinator also participates in committees, educational initiatives, and ongoing performance improvement efforts while serving as a resource on utilization review and documentation standards.
Is this a registered apprenticeship?
False
Place of Work
On-site
Requisition ID
URC
Job Type
Full Time
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