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Utilization Review Manager Jobs in Oklahoma

Utilization Review Coordinator: Rn Or Msw
By The Carolina Center for Behavioral Health At , Greer, 29650
Maintain appropriate records of the Utilization Review Department.
Conducts admission reviews and pre-certs.
Conducts concurrent and extended stay reviews.
Prepares and submits appeals to third party payors.
Participates in activities which enhance professional growth and development.
Demonstrates conduct in keeping with CCBH’s ethical standards.
Utilization Review Specialist Jobs
By Oklahoma Department of Mental Health and Substance Abuse Services At Oklahoma City, OK, United States
Annual Salary is $34,500.00 plus generous benefits package!
Generous state paid benefit allowance to help cover insurance premiums
Training opportunities for CEU requirements
A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
Flexible spending accounts for health care expenses or dependent care
Employee assistance programs and health and fitness programs

Are you looking for a challenging and rewarding role in healthcare? We are seeking an experienced Utilization Review Manager to join our team! You will be responsible for managing the utilization review process, ensuring that all services are medically necessary and appropriate. You will also be responsible for developing and implementing policies and procedures to ensure compliance with applicable regulations. If you have a passion for healthcare and are looking for an opportunity to make a difference, this is the job for you!

A Utilization Review Manager is responsible for overseeing the utilization review process for a healthcare organization. This includes ensuring that all utilization review activities are conducted in accordance with applicable laws and regulations, as well as the organization’s policies and procedures.

What is Utilization Review Manager Skills Required?

• Knowledge of utilization review processes and procedures
• Knowledge of healthcare regulations and laws
• Excellent communication and interpersonal skills
• Ability to analyze data and make decisions
• Ability to work independently and as part of a team
• Ability to manage multiple projects and prioritize tasks
• Proficiency in Microsoft Office Suite

What is Utilization Review Manager Qualifications?

• Bachelor’s degree in healthcare administration, business administration, or related field
• At least 5 years of experience in utilization review
• Certification in utilization review (preferred)

What is Utilization Review Manager Knowledge?

• Knowledge of healthcare reimbursement and coding
• Knowledge of medical terminology
• Knowledge of healthcare quality assurance and improvement
• Knowledge of healthcare data analysis

What is Utilization Review Manager Experience?

• Experience in utilization review management
• Experience in healthcare administration
• Experience in healthcare quality assurance and improvement

What is Utilization Review Manager Responsibilities?

• Develop and implement utilization review policies and procedures
• Monitor utilization review activities to ensure compliance with applicable laws and regulations
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