Clinical Utilization Review Coordinator II
Prime Healthcare
An application made for this job — a tailored resume and cover letter that speak straight to the posting.
Job summary
St. Mary's General Hospital in Passaic, NJ is seeking a Medical Review Coordinator I to lead utilization review activities, coordinate chart reviews, and support discharge planning. The role requires medical graduate or equivalent, 2 years UR experience, and knowledge of pathophysiology and pharmacology; strong communication skills are essential.
Join a large hospital team that emphasizes rigorous review processes and patient-care continuity within a leading healthcare system.
Qualifications
- Must have Medical Graduate, Dental Graduate, PA, or Nursing Graduate.
- Two years of Utilization Review experience as a Medical Review Coordinator I.
- Knowledge of clinical pathophysiology and pharmacology.
Responsibilities
- Coordinate and complete clinical reviews for patient medical records.
- Participate in Case Management and UR meetings with the CMO.
- Educate departments as an on-going resource.
- Review charts to assess admission/continuation criteria and respond to payer requests.
- Coordinate discharge referrals with clinical staff and families.
Skills
Education
Job description
St. Mary's General Hospital in Passaic, NJ is seeking a Medical Review Coordinator I to lead utilization review activities, coordinate chart reviews, and support discharge planning. The role requires medical graduate or equivalent, 2 years UR experience, and knowledge of pathophysiology and pharmacology; strong communication skills are essential.
Join a large hospital team that emphasizes rigorous review processes and patient-care continuity within a leading healthcare system.
'/%3e%3cpath%20d='M101.744%2012.4726L102.894%2016.1947L99.0021%2013.2201L101.744%2012.4726ZM105.3%208.40937H100.488L99.0026%203.59473L97.5116%208.41047L92.7%208.40385L96.5965%2011.3834L95.1055%2016.1942L99.0021%2013.2196L101.408%2011.3834L105.3%208.40992V8.40937Z'%20fill='white'/%3e%3cdefs%3e%3clinearGradient%20id='paint0_linear_5593_1381'%20x1='90'%20y1='9.44471'%20x2='99'%20y2='9.44471'%20gradientUnits='userSpaceOnUse'%3e%3cstop%20stop-color='%2300AD70'/%3e%3cstop%20offset='0.998594'%20stop-color='%2300B67A'/%3e%3cstop%20offset='1'%20stop-color='%23DCDCE6'/%3e%3c/linearGradient%3e%3c/defs%3e%3c/svg%3e){kind=small}
