Top 31 Utilization review Jobs in El Paso, Tx

Utilization Specialist - PRN
Rio Vista Behavioral Health —El Paso, TX
- PRN
- CPR Certification
- Nursing
- RN License
Utilization Specialist - FT
Rio Vista Behavioral Health —El Paso, TX
- Full-time
- CPR Certification
- Nursing
- RN License
12d
Utilization Review Nurse
EL PASO CHILDRENS HOSPITAL CORPORATION —El Paso, TX
- Full-time
- Nursing
- RN License
- Customer service
RC Pre-Authorization Clinician
Conifer Revenue Cycle Solutions —El Paso, TX
- Full-time
- Spanish
- Nursing
- Microsoft Excel
Quality Improvement Coordinator (RN)
The Hospitals of Providence - East Campus —El Paso, TX
- Full-time
- Nursing
- RN License
- Hospital
- Health savings account
- Health insurance
Director of Utilization
Rio Vista Behavioral Health —El Paso, TX
- Full-time
- Nursing
- Management
- RN License
Case Manager II Full Time
Kindred Hospital El Paso —El Paso, TX
- Full-time
- Master of Social Work
- Nursing
- RN License
Utilization Rev Nurse Coord , El Paso Health
University Medical Center of El Paso —El Paso, TX
- Full-time
- Spanish
- Nursing
- RN License
Utilization Management Director, El Paso Health
University Medical Center of El Paso —El Paso, TX
- Full-time
- Microsoft Word
- Nursing
- RN License
Case Manager, PRN
University Medical Center of El Paso —El Paso, TX
- PRN
- Spanish
- Nursing
- RN License
Registered Nurse Case Manager
Las Palmas Medical Center —El Paso, TX
- Full-time
- Mid-level
- Employee stock purchase plan
- Disability insurance
Quick Apply
Therapy Coordinator
Reliant Rehabilitation —El Paso, TX
- PRN
- Customer service
- Physical & Rehabilitation Medicine
- English
- Health insurance
- Dental insurance
5d
Medical Case Manager I - Spanish Speaking Part-Time
CorVel Corporation —El Paso, TX
- $63,739 - $95,264 a year
- Part-time
- Remote
- Spanish
- Nursing
- RN License
- Health savings account
- Disability insurance
Quick Apply
Director of CAD Outpatient Services
Emergence Health Network —El Paso, TX
- $35.06 an hour
- Full-time
- LMFT
- Clean driving record
- Pass drug screening
3h
Nurse Practitioner- Gastroenterology- El Paso, TX
Greater Texas Healthcare Enterprises —El Paso, TX
- Full-time
- Nursing
- RN License
- HIPAA
Advanced Practice Provider
NAUTILUS MEDICAL GROUP INC —El Paso, TX
- Nursing
- Doctoral degree
- Certified Nurse Practitioner
Quick Apply
Board Certified Behavior Analyst (BCBA) - Remote
All Care Therapies —El Paso, TX
- $43 - $56 an hour
- Part-time
- HIPAA
- Psychology
- Mentoring
Quick Apply
10d
Nurse Practitioner- General Surgery
Greater Texas Healthcare Enterprises —El Paso, TX
- Full-time
- Nursing
- Surgery
- RN License
Psychiatrist
IHMS USA, Inc —El Paso, TX
- Full-time
- Medicine
- Psychiatry
- Patient monitoring
- Health insurance
- Dental insurance
Quick Apply
Physician (Radiologist) w/Recruitment-Relocation Incentive-EDRP
US Veterans Health Administration —El Paso, TX
- $350,000 - $390,000 a year
- Choose your own hours
- Background check
- Medicine
- Surgery
- Paid holidays
- Loan repayment program

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utilization review jobs near el paso, tx

Utilization Specialist - PRN

Rio Vista Behavioral Health -
El Paso, TX

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Job Details

Qualifications

CPR Certification
BLS Certification
High school diploma or GED

Full Job Description

Overview:

PURPOSE STATEMENT:

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.

Responsibilities:

ESSENTIAL FUNCTIONS:

Act as liaison between managed care organizations and the facility professional clinical staff.
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
Conduct quality reviews for medical necessity and services provided.
Facilitate peer review calls between facility and external organizations.
Initiate and complete the formal appeal process for denied admissions or continued stay.
Assist the admissions department with pre-certifications of care.
Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.

OTHER FUNCTIONS:

Perform other functions and tasks as assigned.

Qualifications:

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:

Required Education: High school diploma or equivalent.
Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred

LICENSES/DESIGNATIONS/CERTIFICATIONS:

Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
First aid may be required based on state or facility requirements.

ADDITIONAL REGULATORY REQUIREMENTS:

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
(e.g. emergencies, changes in workload, rush jobs or technological developments) dictate.

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

Apply Now

Refine Your Search

utilization review jobs in el paso, tx

Utilization Specialist - PRN

Utilization Specialist - FT

Utilization Review Nurse

RC Pre-Authorization Clinician

Quality Improvement Coordinator (RN)

Director of Utilization

Case Manager II Full Time

Utilization Rev Nurse Coord , El Paso Health

Utilization Management Director, El Paso Health

Case Manager, PRN

Registered Nurse Case Manager

Therapy Coordinator

Medical Case Manager I - Spanish Speaking Part-Time

Director of CAD Outpatient Services

Nurse Practitioner- Gastroenterology- El Paso, TX

Advanced Practice Provider

Board Certified Behavior Analyst (BCBA) - Remote

Nurse Practitioner- General Surgery

Psychiatrist

Physician (Radiologist) w/Recruitment-Relocation Incentive-EDRP

I want to receive the latest job alert for utilization review in el paso, tx

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