Utilization Review Specialist

Providence • Missoula, MT

117d • $25 - $39

About The Position

The Quality Management Reviewer assesses all hospital scheduled procedures and applies guidelines as established by the hospital and outside payer agencies to facilitate payment and appropriate use of hospital resources. The position is responsible for patient pre-certification according to departmental and interdepartmental policies and procedures while adhering to the patient focused admission process. The Quality Management Reviewer demonstrates job related skills in a safe, appropriate, effective and timely manner. Promotes a safe environment of care, to reduce risks and maintain safety in the work area by observing, reporting and responding to safety issues. Providence caregivers are not simply valued they’re invaluable. Join our team at Providence St. Patrick Hospital and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Requirements

• 3 years of experience in a clinical setting.

Nice To Haves

• Associate's Degree in clinical healthcare or business field.
• Bachelor's Degree in clinical healthcare or business field.
• Registered Health Information Technician (RHIT) - American Health Information Management Association upon hire.
• Utilization Management Experience.

Responsibilities

• Assess all hospital scheduled procedures.
• Apply guidelines established by the hospital and outside payer agencies.
• Facilitate payment and appropriate use of hospital resources.
• Responsible for patient pre-certification according to departmental and interdepartmental policies.
• Adhere to the patient focused admission process.
• Demonstrate job related skills in a safe, appropriate, effective and timely manner.
• Promote a safe environment of care.
• Observe, report and respond to safety issues.

Benefits

• 401(k) Savings Plan with employer matching.
• Health care benefits (medical, dental, vision).
• Life insurance.
• Disability insurance.
• Paid parental leave.
• Vacations.
• Holidays.
• Health issues time off benefits.
• Voluntary benefits.
• Well-being resources.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Hospitals
• Education Level: Associate degree