... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
... utilization management, and quality improvement tools and processes in the market * Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Licensed Practical Nurse
Lafayette, IN · On-site
$26 - $30/hr
Reviews symptoms, treatment, and past health/medical history. * Takes B/P, weight, height ... Assists with chart flow/medical records in (RCHC) and for other providers. * Assists with the ...
Quick apply
Licensed Practical Nurse
Lafayette, IN · On-site
$26 - $30/hr
Reviews symptoms, treatment, and past health/medical history. * Takes B/P, weight, height ... Assists with chart flow/medical records in (RCHC) and for other providers. * Assists with the ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Therapist
$55K - $88K/yr
... chart reviews, completing prior requests and pre-certification. • Perform Telehealth services ... utilization of available treatment resources. • Willingness to use reliable personal ...
Supervisor, Crisis Services
Gary, IN · On-site
Review clinical documentation for quality, accuracy, and compliance. * Monitor adherence to ... Monitor service utilization and patient flow. * Ensure compliance with response time expectations ...
Supervisor, Crisis Services
Gary, IN · On-site
Review clinical documentation for quality, accuracy, and compliance. * Monitor adherence to ... Monitor service utilization and patient flow. * Ensure compliance with response time expectations ...
Familiar with reviewing Piping and Instrumentation Diagram (P&ID) flow chart. * Performs site ... Basic PC utilization skills required in Microsoft Office. * Perform jobs in line with OHSA ...
Familiar with reviewing Piping and Instrumentation Diagram (P&ID) flow chart. * Performs site ... Basic PC utilization skills required in Microsoft Office. * Perform jobs in line with OHSA ...
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
... optimal utilization of equipment and maintains necessary patient records and files. 11 ... Reviews patient's chart to confirm existence of allergies and ensures appropriate preoperative lab ...
... optimal utilization of equipment and maintains necessary patient records and files. 11 ... Reviews patient's chart to confirm existence of allergies and ensures appropriate preoperative lab ...
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Reviews requisition, patient's medical chart, and records oral history from patient to define ... Knowledge of all equipment, drug utilization and technical procedures (within assigned area)
Chart Utilization Review information
What is chart utilization review?
Chart Utilization Review is a process commonly used in healthcare settings to assess the necessity, appropriateness, and efficiency of medical services provided to patients. It involves reviewing patient charts and medical records to ensure that treatments and procedures are justified according to established guidelines and policies. This process helps in improving patient care, managing costs, and ensuring compliance with regulatory requirements. Utilization review professionals work closely with medical staff, insurance companies, and regulatory agencies to support quality and cost-effective care.
What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?
Professionals in Chart Utilization Review often encounter challenges such as navigating incomplete or inconsistent medical documentation, staying current with ever-evolving healthcare regulations, and balancing productivity with accuracy. To address these challenges, it is important to maintain open communication with clinical staff, participate in ongoing training, and utilize robust electronic health record systems. Additionally, collaborating closely with interdisciplinary teams can help clarify documentation and ensure compliance with regulatory standards.
What are the key skills and qualifications needed to thrive as a chart utilization review specialist, and why are they important?
To thrive as a Chart Utilization Review specialist, you need a background in healthcare, strong knowledge of medical terminology, and experience with patient care documentation, often supported by an RN or LPN license. Familiarity with utilization management software, electronic health records (EHR), and relevant certifications such as Certified Professional in Utilization Review (CPUR) are typically required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for accurately reviewing charts and collaborating with healthcare providers. These abilities ensure compliance, optimize patient care, and support cost-effective healthcare delivery.
What is the difference between Chart Utilization Review vs Chart Review Specialist?
| Aspect | Chart Utilization Review | Chart Review Specialist |
|---|---|---|
| Credentials | Typically requires healthcare or insurance-related certifications | Often requires medical or coding certifications |
| Work Environment | Healthcare facilities, insurance companies, utilization management teams | Medical offices, insurance companies, coding firms |
| Employer & Industry | Hospitals, insurance providers, healthcare organizations | Medical billing companies, insurance firms, healthcare providers |
| Primary Focus | Assessing medical necessity and appropriateness of services | Reviewing medical records for coding accuracy and completeness |
While both roles involve reviewing medical information, Chart Utilization Review focuses on evaluating the necessity of healthcare services, whereas Chart Review Specialists primarily verify medical documentation for coding and billing accuracy. Understanding these distinctions helps professionals choose the right career path or job search focus.
What are popular job titles related to Chart Utilization Review jobs in Indiana?
For Chart Utilization Review jobs in Indiana, the most frequently searched job titles are:
- Registered Nurse Utilization Review
- Per Diem Chart Review Nurse
- Per Diem Utilization Review Nurse
- Remote Utilization Review Nurse
- Manager Utilization Management
- Part Time Utilization Review Nurse
- No Experience Utilization Management Nurse
- No Experience Utilization Review Nurse
- Night Utilization Review Nurse
- Remote Utilization Management Nurse
What job categories do people searching Chart Utilization Review jobs in Indiana look for?
The top searched job categories for Chart Utilization Review jobs in Indiana are:
Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 10 days ago
Upperline Health rating
3.5
Based on 13 frontline employees who took The Breakroom Quiz
Job description
ABOUT THE ROLE
Upperline Health is seeking a Primary Care Physician, Value Based Care Director to serve as the clinical leader for our Indianapolis, IN market, driving outcomes, quality, and total cost of care for a high-risk population.
This is a dynamic dual impact role combining direct patient care and clinical leadership and VBC program management focused on improving patient outcomes and scaling best practices across the market.
The position will be based in the Indianapolis area to be able to connect with providers, advise on clinical improvements, and assist in market opportunities and growth approximately 30-50% in clinics.
ABOUT US
Upperline Health is the nation s largest multi - specialty value-based care organization, serving 500,000+ patients across 20+ states. We deliver coordinated, high-quality care across primary care, podiatry, vascular, endocrinology, wound care, and chronic condition management.
Our multidisciplinary teams work together to improve outcomes, reduce total cost of care, and make healthcare more connected, accessible, and effective for every patient.
What You ll Do
Upperline Health is seeking a Primary Care Physician, Value Based Care Director to serve as the clinical leader for our Indianapolis, IN market, driving outcomes, quality, and total cost of care for a high-risk population.
This is a dynamic dual impact role combining direct patient care and clinical leadership and VBC program management focused on improving patient outcomes and scaling best practices across the market.
The position will be based in the Indianapolis area to be able to connect with providers, advise on clinical improvements, and assist in market opportunities and growth approximately 30-50% in clinics.
ABOUT US
Upperline Health is the nation s largest multi - specialty value-based care organization, serving 500,000+ patients across 20+ states. We deliver coordinated, high-quality care across primary care, podiatry, vascular, endocrinology, wound care, and chronic condition management.
Our multidisciplinary teams work together to improve outcomes, reduce total cost of care, and make healthcare more connected, accessible, and effective for every patient.
What You ll Do
- Oversee the care management and medical management of Upperline Plus patients being seen by Upperline s Nurse Practitioners in the market
- Direct responsibility for your own small panel of highest-risk patients
- Accountable for value-based care outcomes (e.g., ADK, total cost of care), medical management, care management, utilization management, and quality improvement tools and processes in the market
- Clinical oversight and development of APPs on effectively managing high-risk patients, including chart reviews, performance feedback and education on VBC metrics and best practices
- Review population health data and identify gaps. In collaboration with the Sr. Medical Director and Regional Operations leader, implement solutions to improve delivery of care, decrease hospitalizations, and reduce medical costs
- Implement and manage new value-based care initiatives
- Conduct interdisciplinary team meetings to discuss management of the most complex patients (including high-cost and high-risk patients)
- Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.)
- Board certified in Internal Medicine, Family Medicine, Preventative Medicine, or Geriatrics
- Active license in Indiana and willing to pursue multi-state licensure if needed
- 5 years of outpatient practice experience, inclusive of caring for adult / senior high-risk, polychronic, clinically complex patient populations
- Clinically practiced in a VBC model and/or championed programs to improve patient outcomes and reduce risk
- Must reside in market; be willing and able to provide direct care to a panel of patients and routinely visit clinics and providers within the market
- Clinical leadership and performance management in a VBC or Population Health company or experience working VBC programs (e.g. Transitional Care Management, Complex Care Management, ED Diversion, Advanced Care Planning, High Risk Patient Outreach)
- Owned or been part of creating or implementing initiatives, and/or improving processes, protocols, or workflows
- Compensation is commensurate to compensation for similar positions in the region and based on prior training and experience
- Competitive benefits - comprehensive benefit options include medical, dental and vision, 401K, PTO and parental leave
- Medical malpractice, licensure and board dues paid annually
- CME expense allotment
What Upperline Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Upperline Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
11 - 50 Employees
Headquarters location
Nashville, TN, US
Year founded
2016