Available Positions

Utilization Review Specialist at Hospital in Bronx, New York, United States —

  • Healthcare
  • Hospital
  • Bronx, New York, United States
  • 8/3/20

Job ID: 1030157

Job Description

Establish and maintain positive relationships with patients, visitors, and other employees. Interacts professionally, courteously, and
appropriately with patients, visitors and other employees.  

Behaves in a manner consistent with maintaining and furthering a positive public perception of Bronx-Lebanon Hospital Center and its employee

Performs audits on timeliness of clinical reviews on a weekly basis.
Conducts audits on timeliness of Discharge IMM and 24 hr. notice of discharge.

Responsible for sending discharge deliveries and nursery admission appropriate payers in a timely manner.

Responds to notices related to patient discharge appeals for IPRO and Medicare by collecting and sending clinical information.

Will be responsible for delivering MOON letters for Medicare patients that are on observation.

Conducts audits on UM staff to determine the number of reviews and maintenance of the UM work list in conjunction with the Director and/or Associate Director.

Conducts audits on timeliness of Discharge IMM and 24 hr. notice of discharge.

Responsible for sending discharge deliveries and nursery admission appropriate payers in a timely manner.

Assist with the preparation of the UM Committee meeting including taking/typing minutes.

Responds to notices related to patient discharge appeals for IPRO and Medicare by collecting and sending clinical information.

Will be responsible for delivering MOON letters for Medicare patients that are on observation.

Works with the director/Associate Director to prepare Quarterly PI Reports and other reports as directed. 
 

Qualifications

LPN 

Associate Degree with at least 1 year experience managed care 

Experience in Utilization Management 

Experience in responding to IPRO/Livanta discharge appeals

Excellent interpersonal, written and verbal communication skills
 

Apply

Explore your Recruiting Career

Discover the wide range of opportunities Green Key has to offer.

Learn More

Join Our Network

You’ve worked hard for your industry experience. Now put that experience to work.

Send us your resume

Green Key Blog

News for the way you work.

More from the blog