Top 32 Utilization review Jobs in Lancaster Pa

Clinical Documentation Integrity Manager
Noshen Marketing Consultants —Lebanon, PA
- $30 - $35 an hour
- Full-time
- Anatomy knowledge
- Mid-level
- Team management
- Health insurance
Quick Apply
1d
Home Health Clinical Manager
Centerwell —Lancaster, PA
- $77,200 - $106,200 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
10d
MDS Coordinator - LPN
Confidential —Lancaster, PA
- Full-time
- Hybrid work
- Background check
- Nursing
- Anatomy knowledge
- Health insurance
- Dental insurance
Quick Apply
Care Management Nurse
Wellspan Health —Ephrata, PA
- Part-time
- Acute care
- Nursing
- RN License
- Paid parental leave
- Health insurance
5d
Behavioral Health Community Housing Specialist
Wellspan Health —Lebanon, PA
- Full-time
- Mid-level
- High school diploma or GED
- Driver's License
- Paid parental leave
- Paid time off
11d
Care Nurse Coordinator RN - Behavioral Health Adult Main Inpatient - Days
Wellspan Health —Mount Gretna, PA
- Part-time
- Nursing
- Psychiatry
- RN License
- Retirement plan
Case Manager RN - Good Samaritan Hospital - Days
Wellspan Health —Lebanon, PA
- Part-time
- Acute care
- Nursing
- RN License
Case Management Social Worker - York Case Management - Day
Wellspan Health —York, PA
- Full-time
- Acute care
- Computer literacy
- BLS Certification
- Paid parental leave
- Health insurance
Rehabilitation Liaison - Surgery & Rehab Hospital - Days
Wellspan Health —York, PA
- Weekends as needed
- Nursing
- Surgery
- RN License
- Paid parental leave
- Health insurance
Director-Care Management Operations
Wellspan Health —York, PA
- Full-time
- Nursing
- RN License
- BLS Certification
- Paid parental leave
- Health insurance
Senior Director Care Management
Wellspan Health —York, PA
- Full-time
- Nursing
- RN License
- Hospital
10d
Social Worker Ambulatory Care Manager (Full Time/Days)
Penn Medicine —Parkesburg, PA
- Full-time
- Microsoft Word
- Spanish
- Master of Social Work
- Tuition reimbursement
Quick Apply
Social Worker (Weekend Option 1) - York Case Management - Day
Wellspan Health —York, PA
- Part-time
- Acute care
- Computer literacy
- BLS Certification
- Paid parental leave
- Health insurance
4d
Clinical Reimbursement Coordinator, RN
Sinking Spring Nursing & Rehab —Sinking Spring, PA
- $40 an hour
- Per diem
- CPR Certification
- Nursing
- RN License
- Disability insurance
- Dental insurance
Residential Coordinator
Friendship Community —Lititz, PA
- Overtime
- Writing skills
- Mid-level
- Residential
- Wellness program
- Paid holidays
Quick Apply
Therapist - Substance Use Treatment
Pyramid Healthcare —York, PA
- Full-time
- LMFT
- Addiction Medicine
- Licensed Clinical Social Worker
- Health insurance
- Dental insurance
Quick Apply
5d
Pharmacist
LifeMD —Lancaster, PA
- $120,000 - $140,000 a year
- Full-time
- Inventory management
- Mid-level
- Math
- AD&D insurance
- Paid holidays
Quick Apply
Registered Nurse Supervisor
Jewel Healthcare —Elizabethtown, PA
- $45 - $50 an hour
- Full-time
- Nursing
- Patient monitoring
- RN License
- Free parking
- Paid training
Quick Apply
9d
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance

Discover related jobs

Based on your search for utilization review jobs.

Home Health Clinical Manager
Centerwell —Lancaster, PA
This role is part of Humana's driver safety program and therefore requires an individual to have a valid state driver's license and are expected to maintain…
$77,200 - $106,200 a year
10d
RN Utilization Management - Day Shift
ChristianaCare —Newark, DE
DE RN licensure or compact state RN licensure. Tracks all carve-outs and submits reason codes for data entry. Participates in the development and implementation…
$85,862.40 - $137,384.00 a year
14d

Show more related jobs

Explore jobs in cities nearby

Check out jobs in cities near your current location, Columbus

UR Coordinator, Full Time
RiverVista Behavioral Hospital —Columbus, OH
High school diploma required; associate or bachelor’s degree in nursing, healthcare administration, or related field preferred. Must be 21 or older.
$24 - $32 an hour
Quick Apply
Utilization Review Specialist - Autism
Nationwide Children's Hospital —Columbus, OH
Bachelor’s Degree in Social Work, Psychology, or related field, required. Documents all case reviews and maintains accurate records of all clinical activities…

Show more jobs in cities nearby

I want to receive the latest job alert for utilization review in lancaster pa

By signing in to your account, you agree to SimplyHired's Terms of Service and consent to our Cookie and Privacy Policy.

Explore jobs in more locations

utilization review jobs near lancaster pa

Clinical Documentation Integrity Manager

Noshen Marketing Consultants
Lebanon, PA

Quick Apply

Job Details

Full-time
$30 - $35 an hour
1 day ago

Benefits

Health insurance

Qualifications

Anatomy knowledge
Medicare
Attention to detail
Centers for Medicare & Medicaid Services (CMS) billing regulations
Health information management
Medical terminology

Full Job Description

Job Overview

We are seeking a dynamic and detail-oriented Clinical Documentation Integrity Manager to lead our clinical documentation improvement initiatives. In this pivotal role, you will oversee the accuracy, completeness, and quality of medical records across various healthcare settings. Your expertise will ensure compliance with healthcare regulations, optimize reimbursement processes, and support high-quality patient care. This position offers an exciting opportunity to influence clinical documentation standards and collaborate with multidisciplinary teams to enhance overall healthcare delivery.

Responsibilities

Lead and manage the clinical documentation integrity program, ensuring adherence to industry standards such as NCQA and CMS guidelines.
Collaborate with physicians, nurses, case managers, and health information management teams to improve documentation practices.
Review medical records for completeness, accuracy, and compliance with regulatory requirements including HIPAA, Medicare, Medicaid, and state healthcare regulations.
Utilize advanced electronic health record (EHR) systems such as Epic, Cerner, Athenahealth, eClinicalWorks, and others to facilitate documentation review and data analysis.
Conduct ongoing education and training sessions for clinical staff on documentation standards, coding practices (CPT, ICD-9/10), and regulatory updates.
Monitor key performance indicators related to clinical documentation integrity and implement process improvements accordingly.
Stay current with evolving healthcare policies related to Medicare regulations, long-term care regulations, DRG assignments, utilization management, and hospital accreditation standards.

Qualifications

Proven experience in clinical documentation improvement or medical records management within acute care hospitals or outpatient settings.
Strong knowledge of medical terminology, physiology, anatomy, and nursing practices across various specialties including ICU, emergency medicine, pediatrics, hospice care, and long-term care.
Familiarity with EMR/EHR systems such as Epic, Cerner, Athenahealth, eClinicalWorks; proficiency in Microsoft Office tools is preferred.
In-depth understanding of coding systems including CPT coding (Current Procedural Terminology), ICD-9/10 coding (International Classification of Diseases), DRG assignment processes, and utilization review procedures.
Experience working within managed care environments with knowledge of Medicare and Medicaid policies.
Ability to interpret health regulation policies from CMS and state agencies while ensuring compliance with HIPAA and NCQA standards.
Excellent communication skills for training staff and collaborating across departments; critical thinking skills for analyzing complex medical records.
Relevant certifications such as Certified Coding Specialist (CCS), Certified Professional Medical Auditor (CPMA), or equivalent are highly desirable.

Join our team as a Clinical Documentation Integrity Manager to make a meaningful impact on patient care quality while advancing your career in a fast-paced healthcare environment!

Pay: $30.00 - $35.00 per hour

Benefits:

Health insurance

Work Location: In person

Quick Apply

Refine Your Search

utilization review jobs in lancaster pa

Clinical Documentation Integrity Manager

Home Health Clinical Manager

MDS Coordinator - LPN

Care Management Nurse

Behavioral Health Community Housing Specialist

Care Nurse Coordinator RN - Behavioral Health Adult Main Inpatient - Days

Case Manager RN - Good Samaritan Hospital - Days

Case Management Social Worker - York Case Management - Day

Rehabilitation Liaison - Surgery & Rehab Hospital - Days

Director-Care Management Operations

Senior Director Care Management

Social Worker Ambulatory Care Manager (Full Time/Days)

Social Worker (Weekend Option 1) - York Case Management - Day

Clinical Reimbursement Coordinator, RN

Residential Coordinator

Therapist - Substance Use Treatment

Pharmacist

Registered Nurse Supervisor

Utilization Management Reviewer

Discover related jobs

Explore jobs in cities nearby

I want to receive the latest job alert for utilization review in lancaster pa

Explore jobs in more locations

Job Seeker Tools

Employer Tools

Browse

Stay Connected