Utilization Review Coordinator

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

Job summary

Prime Healthcare is seeking a dedicated Utilization Review Coordinator to support the employee medical benefits program. This role focuses on implementing and managing utilization review to help deliver quality, cost-effective care.

You will collaborate with the Provider Network and Medical Directors across Prime hospitals, utilize available resources, and ensure timely, compliant decisions that benefit members and the organization.

Qualifications

• High School graduate required.
• Proficient in Microsoft Office and common software.
• Typing speed of 40 words per minute.
• Medical Terminology preferred.
• Strong interpersonal skills and professional ethics.

Responsibilities

• Assist with implementation and ongoing management of the utilization review program.
• Coordinate with Prime Healthcare Provider Network and hospital Medical Directors.
• Utilize available resources to provide quality, cost-effective care.

Skills

Microsoft Office proficiency

Typing 40 wpm

Medical terminology

Interpersonal communication

Education

High School diploma

Tools

Word processing

Spreadsheets

Database

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 graduate2. Computer skills, Microsoft Office, proficiency in a variety of software programs3. Typing 40wpm4. Medical Terminology preferred5. Proficient in word processing, spread sheets and database6. 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