Utilization Review Coordinator

Prime Healthcare Management Inc; Ontario (CA); On-site; USD 34,000 - 39,000; Full time

Job summary

Prime Healthcare is seeking a Utilization Review Coordinator to support the implementation and ongoing management of the utilization review program for the employee medical benefits. This role ensures quality, cost-effective care by guiding resource use and services for members.

You will work closely with the Prime Healthcare Provider Network and the hospital Medical Directors to optimize outcomes and coordinate between departments while maintaining accurate records and compliance.

Qualifications

• High School diploma required.
• Typing speed of 40 words per minute or higher.
• Proficient with Microsoft Office and office software.
• Medical terminology preferred.
• Strong interpersonal and professional ethics.

Responsibilities

• Assist with the implementation and ongoing management of the utilization review program for the employee medical benefit plan.
• Provide direction and utilization of resources to ensure quality, cost-effective care.
• Collaborate with Prime Healthcare Provider Network and hospital Medical Directors.

Skills

Typing 40 wpm

MS Office

Medical terminology

Word processing & spreadsheets

Interpersonal skills

Education

High School diploma

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:

• High School graduate
• Computer skills, Microsoft Office, proficiency in a variety of software programs
• Typing 40wpm
• Medical Terminology preferred
• Proficient in word processing, spread sheets and database
• 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