LasVegasRecruiter Since 2001
the smart solution for Las Vegas jobs

Utilization Review Specialist

Company: Desert Parkway Behavioral Healthcare Hospital
Location: Las Vegas
Posted on: April 9, 2021

Job Description:

The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency of medical services and procedures.

  • Performs concurrent and retrospective reviews on all patients. Monitors level and quality of care.
  • Responsible for the proactive management of patients with the objective of improving quality outcomes and decreasing costs.
  • Evaluates and provides feedback to treating physicians regarding a patient's discharge plans and available covered services, including identifying alternative levels of care that may be covered.
  • Monitors all utilization reports to assure compliance with reporting and turnaround times.
  • Addresses care issues with the Director of Clinical Services and Chief Medical Officer/Medical Director as appropriate.
  • Coordinates an interdisciplinary approach to support continuity of care.
  • Provides utilization management, transfer coordnation, discharge planning, and issuance of all appropriate authorization for covered services as needed.
  • Identifies and recommends opportunities for cost savings and improving the quality of care across the continuum.
  • Clarifies health plan medical benefits, policies and procedures for members, physicians, staff, contract providers, and outside agencies. Requirements
    • Current LPN, RN or other Clinical Licensure and/or Master's degree required.
    • Knowledge of medical terminology, medical records, and appropriate medical coding system.
    • Working knowledge with software and/or equipment (Microsoft Office applications including Outlook, Word, Excel and PowerPoint).
    • Maintains confidentiality of patients at all times. Eligible for benefits 1st of the month following 30-days of employment. Desert Parkway offers competitive benefits to include:
      • Health insurance
      • Vision insurance
      • 401K Retirement Plan
      • Healthcare spending account
      • Dependent care spending account
      • PTO Plan with holiday premium pay
      • Discounted cafeteria meal plan
      • Life insurance (Supplemental Life, Term and Universal plans are also available)
      • Short- and long-term disability (with additional buy-in opportunities)

Keywords: Desert Parkway Behavioral Healthcare Hospital, Las Vegas , Utilization Review Specialist, Other , Las Vegas, Nevada

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category

Other Other Jobs

Hair Stylist - Deer Springs Center
Description: Stylist At Great Clips, we know that stylists like you are most happy when they're cutting hair, so at a Great Clips salon, that's exactly what you get to do Want to be the best stylist
Company: Great Clips
Location: Las Vegas
Posted on: 04/12/2021

Bilingual Japanese Customer Service Representative (Work from Home) - Las Vegas
Description: Go Put the World on VacationAt Travel Leisure Co. our goal is simple: to put the world on vacation. We're the world's leading membership and travel company, with a portfolio of nearly 20 resort, travel (more...)
Company: Wyndham Destinations
Location: Las Vegas
Posted on: 04/12/2021

Become a storage host - part-time gig
Description: Neighbor Parking Storage Host Rent out your parking space or your garage and earn 4,000 / year We are looking for side hustlers and passive income lovers to join Neighbor as independent hostsNeighbor (more...)
Company: Neighbor
Location: Dolan Springs
Posted on: 04/12/2021

Navy Chaplain
Description: ABOUT br br The Navy Chaplain Corps boasts more than 800 Navy Chaplains from more than 100 different faith groups, including Christian, Jewish, Muslim, Buddhist and many others. Each Chaplain is also (more...)
Company: Navy
Location: Pahrump
Posted on: 04/12/2021

Description: About the team:Who We Are Eide Bailly is one of the top 25 CPA and business advisory firms in the nation. We have over 40 offices in 14 states across the Midwest and western United States and offer our (more...)
Company: Eide Bailly
Location: Las Vegas
Posted on: 04/12/2021

Restaurant Delivery
Description: Your time. Your Goals.Caviar is a part of DoorDash. When you sign up, you'll join the fleet of independent couriers, called Dashers. Through DoorDash, you can receive either Caviar or DoorDash delivery (more...)
Company: Caviar
Location: Boulder City
Posted on: 04/12/2021

Military Intelligence Officer
Description: About br br The development of useful intelligence starts with the diligent efforts of Navy Intelligence Specialists who break down seemingly limitless raw data into relevant and manageable pieces. (more...)
Company: US Navy
Location: Las Vegas
Posted on: 04/12/2021

Work from Home - List your Garage or Parking Space - $300/mo
Description: Neighbor Parking Storage Host Rent out your parking space or your garage and earn 4,000 / year We are looking for side hustlers and passive income lovers to join Neighbor as independent hostsNeighbor (more...)
Company: Neighbor
Location: Las Vegas
Posted on: 04/12/2021

Description: TKO Staffing LLC is currently seeking entry level janitors to work in commercial building located throughout the Las Vegas metro area. The ideal candidate must be reliable, take pride in their
Company: TKO Construction Services
Location: Las Vegas
Posted on: 04/12/2021

Crewmembers - All Shifts Available - Open Availability - Tropicana Ave.
Description: The Crewmember - At Raising Cane's, What We Do is serve the Perfect Box, Fast, Friendly, Clean Have Fun -- A Crewmember has the primary responsibility of providing a positive Customer experience, (more...)
Company: Raising Cane's
Location: Las Vegas
Posted on: 04/12/2021

Log In or Create An Account

Get the latest Nevada jobs by following @recnetNV on Twitter!

Las Vegas RSS job feeds