Medical Review Coordinator II - Utilization & Case Mgmt

Prime Healthcare; Passaic, Northern (NJ, KY); Hybrid; USD 36,000 - 56,000; Full time

Benefits offered by this job

401K retirement plan

Tuition reimbursement

Job summary

St. Mary's General Hospital in Passaic, NJ is seeking a Utilization Review Coordinator to review patient charts, confirm admission criteria, and coordinate discharge referrals in collaboration with clinical staff and payers.

The role supports case management and UR meetings, and demands strong judgment and independent work capabilities. Qualifications include a Medical, Dental, PA, or Nursing graduate with two years’ UR experience; strong communication and critical thinking skills are essential.

Qualifications

• Two years of Utilization Review experience as a Medical Review Coordinator – I.
• Excellent written and verbal communication skills.
• Excellent critical thinking skills.

Responsibilities

• Review patient charts to assess admission/continuation criteria.
• Coordinate discharge referrals as requested by clinical staff and payers.
• Participate in Case Management and UR meetings and provide education across departments.

Skills

Utilization Review

Communication skills

Critical thinking

Interpersonal skills

Education

Medical or NursingGraduate required

ECFMG Certification preferred

US Health/ Human Services degree preferred

MPH preferred

Job description

St. Mary's General Hospital in Passaic, NJ is seeking a Utilization Review Coordinator to review patient charts, confirm admission criteria, and coordinate discharge referrals in collaboration with clinical staff and payers.

The role supports case management and UR meetings, and demands strong judgment and independent work capabilities. Qualifications include a Medical, Dental, PA, or Nursing graduate with two years’ UR experience; strong communication and critical thinking skills are essential.