Utilization Review Coordinator

Talentify; Ontario (CA); On-site; USD 34,000 - 39,000; Full time

Job summary

Prime Healthcare in Ontario, California seeks a Utilization Review Coordinator to support implementation and ongoing management of the utilization review program for the employee medical benefit plan. You will help ensure cost-effective care and quality outcomes by leveraging available resources and services.

You will collaborate with the Provider Network and hospital Medical Directors, working with cross-functional teams to optimize utilization decisions and program performance.

Qualifications

• High School graduate.
• Computer skills and proficiency with Microsoft Office.
• Typing speed of 40 words per minute.
• Medical terminology preferred.
• Proficient in word processing, spreadsheets and databases.
• Excellent interpersonal relationship skills with strong work ethics.

Responsibilities

• Assist with implementation and ongoing management of the utilization review program for the employee medical benefit program.
• Collaborate with the Prime Healthcare Provider Network and hospital Medical Directors.

Skills

Typing 40 wpm

Interpersonal skills

MS Office

Medical terminology (preferred)

Databases & spreadsheets

Education

High School graduate

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

Responsibilities

The Utilization Review Coordinator is responsible for the assisting with the implementation and ongoing management of the utilization review program for the employee medical benefit program for Prime Healthcare. This position will provide assistance in the direction and utilization of available resources to provide quality, cost effective care using selected benefits and alternative services best suited for the members while ensuring optimal outcomes. This position will work closely with the Prime Healthcare Provider Network and with each of the hospital’s Medical Directors.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

• 1. High School graduate
• 2. Computer skills, Microsoft Office, proficiency in a variety of software programs
• 3. Typing 40wpm
• 4. Medical Terminology preferred
• 5. Proficient in word processing, spread sheets and database
• 6. Excellent interpersonal relationship skills with exceptional professional work ethics.

Pay Transparency

Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $24.77 to $28.25. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

Privacy Notice

Privacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf