Utilization Review Coordinator

Are you a highly organized and detail-oriented professional looking to take the next step in your healthcare career? HOAG is looking for an enthusiastic and experienced Utilization Review Coordinator to join our team!The ideal candidate will bring extensive knowledge of medical terminology and coding, as well as experience in utilization review. You must be able to work independently and be a self-starter who can easily assess and respond to the changing needs of the department. A motivated and team-oriented attitude is essential to the role.In this role, you will be responsible for ensuring that all utilization review processes and activities adhere to all standards and regulations. You will have the opportunity to work closely with various departments and providers and collaborate to ensure efficient utilization of resources.If you are looking for a role with responsibility, impact, and the ability to grow and develop, this could be the perfect opportunity for you!

Responsibilities:

1. Monitor utilization review processes and activities to ensure compliance with standards and regulations.
2. Collaborate with various departments and providers to ensure efficient utilization of resources.
3. Maintain up-to-date knowledge of medical terminology and coding.
4. Analyze cases to determine medical necessity for services provided.
5. Evaluate discharge plans to ensure appropriate care is provided.
6. Prepare and submit reports to management as needed.
7. Communicate with stakeholders regarding utilization review issues and concerns.
8. Provide education and training to clinical and administrative staff related to utilization review processes.
9. Develop and implement quality improvement initiatives to ensure optimal outcomes.
10. Maintain documentation of utilization review activities.

According to JobzMall, the average salary range for a Utilization Review Coordinator in Newport Beach, CA, USA is $42,541 to $71,068.

Hoag is a not-for-profit regional health care delivery network in Orange County, California, that treats nearly 30,000 inpatients and 350,000 outpatients annually. Hoag consists of two acute-care hospitals, seven health centers and four urgent care centers.