Warbird Consulting Partners

  • Utilization Review Coordinator

    Location
    New Jersey
    Pos. Category
    Healthcare - Consulting
    Experience (Years)
    3
    # Positions
    1
    Job ID
    6545
  • Job Description

    Warbird seeks experienced Utilization Review Coordinator for a current project with a healthcare system in the Northeast. The consultants will be responsible for the coordination of services through the continuum of care to ensure delivery of quality patient care with the cost-effective utilization of resources.  

     

    Essential duties, but not limited to:

    • Perform concurrent clinical review to determine appropriateness of admission and continued need for care delivery
    • ED Gatekeeper responsibilities
    • Review clinical documentation for nurses and physicians for Quality Assurance
    • Communicate with patient/family and entire health care team regarding the patient's plan of care and continued needs post-discharge
    • Perform clinical reviews with claims insurance personnel to facilitate reimbursement for the delivery of patient care services
    • Identify quality and/or risk issues and report to the appropriate individual/department
    • Submit mandatory reports to payors and regulatory agencies
    • Participate in education of the new staff (orientation and on on-going filed support) as needed

    Warbird engages talent and expertise across all of our practice areas and assembles experienced teams to solve a wide range of complex, pressing accounting and finance issues. Our consultants typically have 15-25 years plus of industry experience and know firsthand the daily challenges our clients encounter. We fit our consultants’ skills to the needs of our clients to ensure a successful experience for all. If you’re ready to take on the challenge, then let us help you advance your career in consulting.

    Job Requirements

     

    • Bachelor's degree in nursing (BSN) or Associate degree in nursing.
    • 3+ years of direct patient care experience as a registered nurse.
    • Knowledge of Medicare and Medicaid payment rules, policies and regulations.
    • Strong written and verbal communication skills.
    • Knowledge of MS Office products such as MS Word and MS Outlook.
    • Ability to evaluate medical records and other health care data.
    • Effective and professional presentation skills.

      

    Preferred (not required) Skills

    • Certification in care coordination or utilization review.
    • Prior experience as an RN Care Coordinator.
    • Required:  Onsite presence in the client location during the week.

    This position is projected to last 6-9-months and requires to ability to be present at the client site;  remote times to be determined later in the project.

     

     E-Verify - Warbird participates in the Electronic Employment Eligibility Verification Program. Warbird is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, religion or other legally protected status.

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