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Chart Utilization Review Jobs in Kansas (NOW HIRING)

CenterWell

Clinical Care Nurse Educator

Topeka, KS · On-site

... chart review, data review, and provide guidance to ensure that the quality of care being provided meets appropriate standards and to ensure cost-effective utilization practices for new and current ...

restorixhealth

Lead Nurse RN - Full Time

Minneola, KS · On-site

$29.50 - $40/hr

Review wound healing center activities and recommend process flow changes in, or better utilization ... Ensures accuracy, legibility, and completion of all staff documentation and adheres to daily chart ...

Restorixhealth

Lead Nurse RN - Full Time

Minneola, KS · On-site

$29.50 - $40/hr

Review wound healing center activities and recommend process flow changes in, or better utilization ... Ensures accuracy, legibility, and completion of all staff documentation and adheres to daily chart ...

RestorixHealth, Inc.

Lead Nurse RN - Full Time

Minneola, KS · On-site

$80K - $90K/yr

Review wound healing center activities and recommend process flow changes in, or better utilization ... Ensures accuracy, legibility, and completion of all staff documentation and adheres to daily chart ...

Ossur

Patient Care Specialist

Newton, KS

$15.75 - $20.25/hr

Primary responsibilities include greeting and registering patients, compiling complete chart ... Takes patient height, weight and reviews relevant medical history with patient. Prepares treatment ...

All JobsChart Utilization Review JobsChart Utilization Review Jobs in Kansas

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?

AspectChart Utilization ReviewChart Review Specialist
CredentialsTypically requires healthcare or insurance-related certificationsOften requires medical or coding certifications
Work EnvironmentHealthcare facilities, insurance companies, utilization management teamsMedical offices, insurance companies, coding firms
Employer & IndustryHospitals, insurance providers, healthcare organizationsMedical billing companies, insurance firms, healthcare providers
Primary FocusAssessing medical necessity and appropriateness of servicesReviewing 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 Kansas?

For Chart Utilization Review jobs in Kansas, the most frequently searched job titles are:

What job categories do people searching Chart Utilization Review jobs in Kansas look for?

The top searched job categories for Chart Utilization Review jobs in Kansas are:

What cities in Kansas are hiring for Chart Utilization Review jobs?

Cities in Kansas with the most Chart Utilization Review job openings:

Chart Utilization Review jobs near you
Infographic showing various Chart Utilization Review job openings in Kansas as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 14% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Utilization Reviewer

Lawrence, KS • On-site

Bert Nash Community Mental Health Center
Offices of Mental Health Practitioners • 51 - 200 employees

6.2

Company rating: 6.2 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

Learn more about Bert Nash Community Mental Health Centerexternal

$65K - $70K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 3 days ago

Job description

Utilization Reviewer
Pay is commensurate with experience within a range of $65,000 to $70,000 annually. Full time, exempt, benefits eligible. Bert Nash offers excellent benefits which include medical, dental, vision, KPERS retirement, life insurance, an Employee Assistance Program (EAP) providing free counseling and resources, and generous PTO.
Caring. Hope. Giving back. Our mission at the Bert Nash Center as the Community Mental Health Center (CMHC) of Douglas County is to advance the health of the community through comprehensive behavioral health services responsive to evolving needs and changing environments. We accomplish this by believing in our team. Each person that works for the Bert Nash Center contributes directly to the success of our clients, organization, and community. Our values of compassion, integrity, equity and hope reflect in everything we do.
The Utilization Reviewer's primary responsibility is to manage and complete monthly clinical record reviews to ensure provision of clinically appropriate care is delivered to clients in the least restrictive but clinically appropriate level as quickly as possible while complying with agency, payers, applicable policies, regulations and accreditation standards. This role's overall goal is to ensure that quality services are provided in the most efficient, cost-effective manner to all eligible clients seeking treatment regardless of the treatment setting or payer.
Responsibilities: The primary responsibility of the Utilization Reviewer is to ensure clinical documentation achieves expected standards, implement and train for consistency in best practices across the organization's facilities, participate and coordinate with teams Quality Improvement Plans or related initiatives. Duties will include but not limited to:
  • Conduct monthly clinical chart reviews to assure clients receive clinically appropriate care and complies with agency, payor, applicable policies, regulations and accreditation standards.
  • Utilize evidence-based calculation to ensure the sample size of charts reviewed provide a high confidence level that results are valid and reliable.
  • Provide chart review results to program directors or managers with both aggregate program data and individual charts needing remediation.
  • Work with directors or program managers on remediation activities to ensure they are completed within 30 days.
  • Meet with teams to help identify and develop continuous quality improvement goal(s) to improve the quality of documentation.
  • Managing organizational risks through implementation and improvement of best practices in clinical documentation, CCBHC regulations, CARF standards and other regulatory requirements.
  • Provide or coordinate the provision of related trainings in collaboration with the Clinical Consultant, Clinical Educator, and other team members.
  • Provides response to clinical quality questions.
  • Champions continuous quality improvement and assists in developing, tracking, and realizing related organizational goals or objectives.
  • Assign, analyze and present the quarterly chart review data for all teams per CARF Standards 2.G. and 2.H.
  • Analyzes monthly chart reviews to identify both areas needing improvement and areas that have improved since previous audits.
  • Maintain and record inventories of chart review occurrences and results.
Qualifications include but not limited to:
  • Licensure in social work, counseling, nursing or psychology.
  • Knowledge and familiarity with electronic health record (EHR) documentation.
  • Three years of experience providing billed services to clients in fields such as nursing, counseling, psychology, therapy, medication management, case management, or other.
  • Master's degree in behavioral health, medical services or administration, nursing, psychology, sociology, or similar.
  • Ability to accurately interpret standards from policies, contracts, and accrediting bodies for implementation.
  • Flexibility in assigned working hours.
  • Ability to negotiate, complete contracted work, analyze operations, and governmental/accrediting body regulations.
  • Interest or experience in quality improvement, quality assurance, or similar background and/or training a plus.
  • Have exemplary existing skills in clinical documentation and familiarity with using EHRs to complete documentation reviews, as well as external tools such as the Microsoft Office Suite.
  • Assist QI team with other duties as needed.

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