[Hiring] Utilization Review Coordinator @Franciscan Alliance, Inc.

Role Description

The Utilization Review Coordinator performs admission screening for patients in a bed for medical necessity, and reviews for appropriateness of setting and utilization.

WHAT YOU CAN EXPECT:

• Schedule: Monday - Friday, 8am - 4:30pm EST
• Perform concurrent reviews for appropriateness of utilization to optimize clinical and financial outcomes.
• Communicate with physicians, patients, members of the Healthcare team, Coordinated Business Office staff, Denial Management staff, and third-party payors to justify the admission or continued stay.
• Notify appropriate staff members of any admission, service, length of stay, lack of medical necessity criteria, as well as denials/appeals and issuing of letters to patients.
• Provide Physician, Patient, Family, Staff and Student education.
• Act as a resource person for the case management department regarding payer rules, regulations, policies and procedures, and utilization issues.
• Perform admission necessity screening using criteria as established by the various federal, state and private sector programs.

Qualifications

• Associate degree in nursing/patient care required
• Bachelor's Degree in nursing/patient care preferred
• Registered Nurse (RN - Indiana licensure) required
• 3 years of nursing/patient care experience required
• 2 years of Utilization or Case Management experience preferred

Requirements

• TRAVEL IS REQUIRED: Never or Rarely
• JOB RANGE: Utilization Review Coordinator $56971.20-$84749.60
• INCENTIVE: Not Applicable

Benefits

Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.

Company Description

With 11 ministries and access points across Indiana, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve.