... utilization Review experience. 3. Coursework and experience in research statistics and quality improvement methodology, including chart control techniques, preferred.
... utilization Review experience. 3. Coursework and experience in research statistics and quality improvement methodology, including chart control techniques, preferred.
OASIS REVIEW SPEC
Troy, MI · On-site
... Competitive per-chart rate ✔ Collaborative, quality-driven team Make an impact on patient ... Review visit utilization for appropriateness and potential under/over-utilization * Communicate ...
New
Quick apply
OASIS REVIEW SPEC
Troy, MI · On-site
... Competitive per-chart rate ✔ Collaborative, quality-driven team Make an impact on patient ... Review visit utilization for appropriateness and potential under/over-utilization * Communicate ...
New
PAS Physician Advisor (Level of Care / Admission Status Review)
Detroit, MI · On-site
$150K - $199K/yr
Previous experience with utilization review or chart review For this US-based position, the base pay range is $150,075.00 - $199,070.29 per year . Individual pay is determined by role, level ...
PAS Physician Advisor (Level of Care / Admission Status Review)
Detroit, MI · On-site
$150K - $199K/yr
Previous experience with utilization review or chart review For this US-based position, the base pay range is $150,075.00 - $199,070.29 per year . Individual pay is determined by role, level ...
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Saginaw, MI · On-site
$100 - $130/hr
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Saginaw, MI · On-site
$100 - $130/hr
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Saginaw, MI · On-site
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Saginaw, MI · On-site
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Dearborn Heights, MI · On-site
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Dearborn Heights, MI · On-site
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Saginaw, MI · On-site
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Chief Dental Officer
Saginaw, MI · On-site
... utilization review and external and internal referrals. (10%) * Responsible for the staffing at all GLBHC dental sites. (18%) * Responsible for chart audits for dental quality assurance, grant ...
Clinical Manager - Behavioral Health
Detroit, MI · On-site
$59K - $81K/yr
Run chart reviews, utilization review, and QA; lead audits and corrective action plans * Oversee CPT coding and billing workflows; partner with finance on medical necessity and payer requirements
Quick apply
Clinical Manager - Behavioral Health
Detroit, MI · On-site
$59K - $81K/yr
Run chart reviews, utilization review, and QA; lead audits and corrective action plans * Oversee CPT coding and billing workflows; partner with finance on medical necessity and payer requirements
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
Be Seen First
Clinical Manager - Non-Profit Organization
Dearborn, MI · On-site
$80K - $90K/yr
Ensure documentation quality and timeliness; conduct chart reviews, utilization review, and quality assurance (QA) activities. Knowledge, Skills, and Abilities: * Behavioral health clinical practice ...
New
Quick apply
Be Seen First
Clinical Manager - Non-Profit Organization
Dearborn, MI · On-site
$80K - $90K/yr
Ensure documentation quality and timeliness; conduct chart reviews, utilization review, and quality assurance (QA) activities. Knowledge, Skills, and Abilities: * Behavioral health clinical practice ...
New
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
... annual review of patient health records and utilization review studies of Clinic services ... Notate findings and treatment course in patient electronic chart including follow-up notes.
Behavioral Health Clinician - Home-Based Genesee County
Flint, MI · On-site +1
$60K - $82K/yr
Responsible for maintaining an electronic and paper chart which includes required documentation of ... Participate in utilization review committee meetings for the purpose of reviewing case records for ...
Behavioral Health Clinician - Home-Based Genesee County
Flint, MI · On-site +1
$60K - $82K/yr
Responsible for maintaining an electronic and paper chart which includes required documentation of ... Participate in utilization review committee meetings for the purpose of reviewing case records for ...
Behavioral Health Clinician - Home-Based Genesee County
Flint, MI · On-site +1
$60K - $82K/yr
Responsible for maintaining an electronic and paper chart which includes required documentation of ... Participate in utilization review committee meetings for the purpose of reviewing case records for ...
Behavioral Health Clinician - Home-Based Genesee County
Flint, MI · On-site +1
$60K - $82K/yr
Responsible for maintaining an electronic and paper chart which includes required documentation of ... Participate in utilization review committee meetings for the purpose of reviewing case records for ...
Case Manager-Social Worker MIDNIGHTS
Detroit, MI · On-site
$21.50 - $28.25/hr
Knowledge of social work practices, individuals, case recording, chart documentation, community ... Knowledge of computers, Electronic Health Records, data base systems and utilization review/case ...
Case Manager-Social Worker MIDNIGHTS
Detroit, MI · On-site
$21.50 - $28.25/hr
Knowledge of social work practices, individuals, case recording, chart documentation, community ... Knowledge of computers, Electronic Health Records, data base systems and utilization review/case ...
Case Manager-SW Afternoons
Detroit, MI · On-site
$19.75 - $25.50/hr
Knowledge of social work practices, individuals, case recording, chart documentation, community ... Knowledge of computers, Electronic Health Records, data base systems and utilization review/case ...
Case Manager-SW Afternoons
Detroit, MI · On-site
$19.75 - $25.50/hr
Knowledge of social work practices, individuals, case recording, chart documentation, community ... Knowledge of computers, Electronic Health Records, data base systems and utilization review/case ...
Chart Utilization Review information
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 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 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 Michigan?
For Chart Utilization Review jobs in Michigan, the most frequently searched job titles are:
- Utilization Management
- Registered Nurse Utilization Review
- Weekend Physician Advisor Utilization Review
- Rn Legal Nurse Chart Review
- No Experience Utilization Review Nurse
- Per Diem Chart Review Nurse
- Optum Clinical Claim Review Nurse
- Night Shift Remote Utilization Review Nurse
- Full Time Physician Advisor Utilization Review
- Utilization Review Nurse
What job categories do people searching Chart Utilization Review jobs in Michigan look for?
The top searched job categories for Chart Utilization Review jobs in Michigan are:
- Manager Optum Utilization Review
- Night Shift Optum Utilization Review
- From Home Anthem Utilization Review Nurse
- Per Diem Optum Utilization Review
- Remote Rn Utilization Review Nurse
- Remote Navihealth Utilization Review
- Remote Hca Utilization Review
- Remote International Utilization Review Nurse
- Registered Nurse Case Review
- Remote Weekend Utilization Review
What cities in Michigan are hiring for Chart Utilization Review jobs?
Cities in Michigan with the most Chart Utilization Review job openings:
Part-time
Re-posted 24 days ago
Tenet Healthcare rating
6.2
Based on 352 frontline employees who took The Breakroom Quiz
701st of 887 rated healthcare providers
Job description
Children’s Hospital of Michigan is an international leader in pediatric and adolescent medicine. Surgical services include general, thoracic, reconstructive and cardiovascular. Imaging technology designed specifically for children provides advanced diagnostic services including Positron Emission Tomography (PET) and MRI. The Children’s Hospital of Michigan Emergency Department is a verified Level 1 Pediatric Trauma Center and dedicated pediatric burn center. Experts in pediatric critical care, rehabilitation, and neonatal and perinatal medicine provide care for thousands of children every year at Children’s Hospital of Michigan, Children’s Hospital of Michigan - Troy and six ambulatory sites.
Job Summary
Under general direction and according to established policies and procedures, monitors patient care for quality assurance, utilization review and risk management activities. Determines appropriateness and medical necessity of admission, continued hospital stay and use of ancillary services. May perform pre-authorizations, concurrent review and retrospective review audits.
May troubleshoot patient issues with Patient Management, as needed. Reviews and monitors patient medical records for complete, timely and accurate entries.
Communicates with third party payors and develops appeals to overturn adverse payment decisions; provides technical assistance to clinical and administrative staff regarding the development of quality improvement indicators/monitors, measurement methodology and charting techniques; conducts special studies and prepares report findings.
May participate in the development, education and maintenance of the DMC Continuous Improvement Program.
Facilitates the preparation of JCAHO and other licensing body requirements of accreditation. Develops and presents in-services to clinical and administrative staff regarding documentation and findings from reviews, as necessary.
1. Bachelors degree in Nursing, Medical Records or health care field, or equivalent combination of education and/or related experience. Registered Nurse preferred.
2. Two to three years progressively more responsible clinical and/or Quality Assurance/utilization Review experience.
3. Coursework and experience in research statistics and quality improvement methodology, including chart control techniques, preferred.
What Tenet Healthcare employees say
Pay
Benefits
Hours and flexibility
Workplace
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About Tenet Healthcare
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Dallas, TX, US
Year founded
1969