Top 18 Utilization review Jobs in Springfield, Oh

Utilization Review Coordinator
Neuropsychiatric Hospitals —Huber Heights, OH
- Full-time
- Nursing
- Psychiatry
- Mid-level
- Health insurance
- Dental insurance
Registered Nurse - Utilization Manager
Decypher —Wright-Patterson AFB, OH
- $44.92 an hour
- 8 hour shift
- Bachelor of Science
- Mid-level
- Ability to sit for extended periods
Quick Apply
CSI ANALYST/SYSTEM SUPPORT-MVH/FT
System Support —Dayton, OH
- Full-time
- Microsoft Word
- Nursing
- RN License
14d
Case Manager PRN
Kindred Hospital Dayton —Dayton, OH
- PRN
- Master of Social Work
- Nursing
- Computer literacy
THERAPIST LISW/PCC
Samaritan Behavioral Health In —Dayton, OH
- LMFT
- CPR Certification
- Psychiatry
THERAPIST-BSW/LSW-YCATS
Samaritan Behavioral Health In —Dayton, OH
- Part-time
- CPR Certification
- Customer service
- Computer literacy
- Continuing education credits
- Health insurance
THERAPIST LSW/PC
Samaritan Behavioral Health In —Troy, OH
- Full-time
- LMFT
- Customer service
- LPC
Business Office Manager
Riverside Healthcare Center —Dayton, OH
- Full-time
- Microsoft Excel
- Skilled nursing facility
- Computer literacy
- Health insurance
- Dental insurance
Quick Apply
CASE MANAGER / REGISTERED NURSE / RN
Upper Valley Medical Center —Troy, OH
- Nursing
- RN License
- Hospital
23h
Case Manager
TCN BEHAVIORAL HEALTH SERVICES INC —Xenia, OH
- $19 - $21 an hour
- CPR Certification
- Experience working with individuals with disabilities
- Computer literacy
Quick Apply
MDS Nurse Transition Leader
Otterbein SeniorLife —Dayton, OH
- Nursing
- RN License
- 5 years
- Paid holidays
- Dental insurance
Quick Apply
Therapist
TCN BEHAVIORAL HEALTH SERVICES INC —Xenia, OH
- Full-time
- Mid-level
- Bachelor's degree
- Psychology
Quick Apply
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance
Remote Psychologist - US Location
APN Staffing & Employment Solutions —United States
- $100,000 a year
- Full-time
- Remote
- Word processing
- Writing skills
- Mid-level
Quick Apply
6d

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Registered Nurse - Utilization Manager
Decypher —Wright-Patterson AFB, OH
Full-time employment in a nursing field within the last 36 months is required. Navigate electronic health records and TRICARE managed care contractor sites.
$44.92 an hour
Quick Apply
CASE MANAGER - South Campus
Miami Valley Hospital South —Centerville, OH
Valid RN license with the State of Ohio. Exemplary interpersonal skills as demonstrated by the ability to develop and maintain rapport with physicians and…

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CDCA Case Manager – Substance Use Treatment
Seacrest Recovery Center —Columbus, OH
Associate or bachelor’s degree in social work, psychology, behavioral health, human services or a related field preferred.
$20 - $22 an hour
Quick Apply
1d
Case Manager / PRN ( RN / RT / SW / LPN )
Select Specialty Hospital - Columbus Vic Village(Grant) —Columbus, OH
Current licensure in a clinical discipline either as a Nurse (RN /LPN/ LVN)or a Respiratory Therapist OR current license / certified Social Work license per…
Quick Apply

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utilization review jobs near springfield, oh

Utilization Review Coordinator

Neuropsychiatric Hospitals -
Huber Heights, OH

Apply Now

Job Details

Full-time

Benefits

Health insurance
Dental insurance
Paid time off
Employee assistance program
Vision insurance
Employee discount

Qualifications

Customer communication
Employee relationship building
Transitional care planning in clinical case management
Bachelor's degree
Clinical data entry
Utilization management
Resource utilization in healthcare
Managing patients as a clinical case manager
Hospital experience
Quality data entry

Full Job Description

About Us:

Healing Body and Mind.

NeuroPsychiatric Hospitals is a national leader in behavioral healthcare, specializing in patients with acute psychiatric and complex medical needs. Our hospitals use an interdisciplinary, multi-specialty approach that delivers high-quality, patient-centered care when it’s needed most.

With locations in Indiana, Michigan, Texas, and Arizona, we’re expanding access to our unique model of care across the United States. Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day

Overview:

North Valley Behavioral Hospital, a brand new psychiatric hospital within the NeuroPsychiatric Hospitals network, is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with multidisciplinary teams.

Benefits of joining NPH

Competitive pay rates
Medical, Dental, and Vision Insurance
NPH 401(k) plan with up to 4% Company match
Employee Assistance Program (EAP) Programs
Generous PTO and Time Off Policy
Special tuition offers through Capella University
Work/life balance with great professional growth opportunities
Employee Discounts through LifeMart

Responsibilities:

Filing documents as needed.
Initial Precertification with payors.
Concurrent Clinical review with payors.
Document in the electronic system daily in real time.
Admission audit.
Ensures that CON’s/RON’s and CMS certifications are completed by provider.
Consistently demonstrates professionalism with all internal and external customers as evidenced by positive customer and peer Communicates effectively with all staff and patients as evidenced by the establishment and maintenance of productive working relationships.
Maintains knowledge of current trends and developments in the field by reading appropriate books; journals and other literature and attending related seminars or conferences.
Maintains a professional approach with Assures protection and privacy of health information as attained through written, electronic or oral disclosures.
Cooperates and maintains good rapport with nursing staff, medical staff, and other departments.
Seeks guidance and remains knowledgeable of, and complies with, all applicable federal and state laws, as well as hospital polices that apply.
Complies with hospital expectations regarding ethical behavior and standards of conduct.
Complies with federal and hospital requirements in the areas of protected health information and patient information.
Reconsiderations, assists with appeals as needed, arrange peer to peer level reviews, and report the outcomes to the VP of Care Management and Team.
Provides education to nursing staff. leadership team, and providers regarding documentation.
Actively works with the business office regarding resolution of appeals/denials and retrospective reviews.

Qualifications:

Education: Bachelor's in Behavioral Health, Social Work, Counseling, Nursing or Psychology required. Master's degree preferred.

Experience: Minimum of 2 years of utilization review experience in a hospital setting required. Minimum of 2 years of case management experience, including discharge planning in a hospital setting required.

Licensure: Certified Case Manager (CCM) or Accredited Case Manager (ACM) preferred. Basic Life Support (BLS) and Handle with Care (HWC) obtained during orientation, if applicable.

Skills: Must have strong knowledge of medications and demonstrate exceptional time management, data entry, and communication skills. Must be detail oriented.#INDEEDLOW

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utilization review jobs in springfield, oh

Utilization Review Coordinator

Registered Nurse - Utilization Manager

CSI ANALYST/SYSTEM SUPPORT-MVH/FT

Case Manager PRN

THERAPIST LISW/PCC

THERAPIST-BSW/LSW-YCATS

THERAPIST LSW/PC

Business Office Manager

CASE MANAGER / REGISTERED NURSE / RN

Case Manager

MDS Nurse Transition Leader

Therapist

Utilization Management Reviewer

Remote Psychologist - US Location

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