Hospital - UR Care Coordinator

Job description

The Utilization Review (UR) Care Coordinator in the Care Management Department will be responsible for ensuring the appropriate use of healthcare resources while maintaining high standards of patient care.  The individual in this position will review patient cases, monitor treatment plans, and collaborate with healthcare providers to optimize care delivery and resource utilization. Education: - Conduct utilization reviews to ensure medical necessity, appropriateness, and efficiency of healthcare services. - Evaluate patient records, treatment plans, and clinical documentation to verify that services meet established guidelines and standards. - Collaborate with physicians, nurses, case managers, and other healthcare providers to discuss patient care and identify opportunities for improvement. - Facilitate the authorization process for hospital admissions, treatments, and procedures with insurance companies and payers - Monitor patient progress and discharge plans to ensure timely and appropriate transitions of care. - Educate patients, families, and healthcare providers about utilization review processes and requirements. - Maintain accurate and detailed documentation of review...