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Chart Utilization Review Jobs in Minnesota (NOW HIRING)

ARC Health

Clinical Care Coordinator (TMS)

Lake Elmo, MN · On-site

$25 - $27/hr

... schedule utilization. * Identify and escalate operational barriers: scheduling gaps, workflow ... Ensure chart completion, data accuracy, and timely documentation uploads. * Maintain clinic ...

Mercy

Clinical Pharmacist - PRN Overnight (Ada, OK)

Anoka, MN · On-site

$120K - $144K/yr

... planning and utilization of resources. d. Supports the continuing education initiative of the ... Monitors drug therapy through chart or patient profile reviews and interactions with other health ...

Range Mental Health Center

Registered Nurse

Virginia, MN · On-site

$31.20 - $44.18/hr

... improve utilization of evidence-based practices on a more consistent basis. As part of our ... Provide chart audits, policy review, updating of policy and procedures as requested to assure ...

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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 Minnesota?

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

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

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

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

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

Chart Utilization Review jobs near you
Infographic showing various Chart Utilization Review job openings in Minnesota as of August 2026, with employment types broken down into 73% Full Time, and 27% Part Time. Highlights an 100% In-person job distribution.

Clinical Documentation Integrity Specialist

Fairview Health Services

Saint Paul, MN • On-site

$81K - $115K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired 4 days ago. Applications are no longer accepted.

Fairview Health Services rating

7.7

Company rating: 7.7 out of 10

Based on 251 frontline employees who took The Breakroom Quiz

163rd of 898 rated healthcare providers

Job description

Job Overview
Job Overview
Fairview is looking for a Clinical Documentation Integrity Specialist to join our team. The CDI Specialist performs concurrent inpatient chart reviews for documentation improvement opportunities. Communicates with physicians to facilitated comprehensive medical record documentation to reflect clinical treatment and diagnoses, uses hospital's CDI software to identify opportunities, evaluates documentation on a day-to-day basis, gathers and analyzes information pertinent to findings and outcomes, arranges formal and informal education sessions for all providers, formulated a DRG and confers with coders to ensure appropriate DRG. This review process assures the quality of the documentation used for patient care, regulatory compliance, and reimbursement.
Responsibilities
  • Completes a concurrent review of the medical record for assigned patients in the required timeframe.
  • Performs daily case reviews and identifies diagnoses and procedures in order to assign in accurate working DRG. Performs follow-up medical record reviews to identify any additional diagnoses or procedures that may impact the DRG assignment. Confers with coders to ensure appropriate final DRG and completeness of supporting documentation.
  • Develops physician education strategies to promote complete and accurate clinical documentation and correct negative trends. Confers with nursing, case management, utilization review and other clinical caregivers to explain the importance of clear and concise documentation.
  • Collects and analyzes data showing the activities performed, results of interactions, improvements made in clinical documentation, and distribution of DRGs and case mix index.
  • Organization Expectations, as applicable:
  • Demonstrates ability to provide care or service adjusting approaches to reflect developmental level and cultural differences of population served
  • Partners with patient care giver in care/decision making.
  • Communicates in a respective manner.
  • Ensures a safe, secure environment.
  • Individualizes plan of care to meet patient needs.
  • Modifies clinical interventions based on population served.
  • Provides patient education based on as assessment of learning needs of patient/care giver.
  • Fulfills all organizational requirements
  • Completes all required learning relevant to the role
  • Complies with and maintains knowledge of all relevant laws, regulation, policies, procedures and standards.
  • Fosters a culture of improvement, efficiency and innovative thinking.
  • Performs other duties as assigned

Required Qualifications
Education
  • Associates Degree in Nursing or Health Information Management (HIM) degree or related field or equivalent experience

Experience
  • 2 years Acute/Inpatient experience as an RN or
  • 5 years inpatient coding experience

Licensure
  • Registered Nurse of MN Upon Hire or
  • current Registered Health Information Administrator (RHIA) MN Board of Nursing or American Health Information Management Association Upon Hire or
  • Registered Health Information Tech (RHIT) MN Board of Nursing or American Health Information Management Association Upon Hire

Skills
  • Knowledge of clinical documentation requirements related to regulatory and reimbursement rules and regulations
  • Knowledge of current coding and DRG classification systems
  • Knowledge of medical terminology, anatomy and pathophysiology, pharmacology, ancillary test results
  • Knowledge of ICD-10-CM and DRG classification systems
  • Knowledge of physician and nursing unit practices
  • Excellent interpersonal, critical thinking and conflict management skills
  • Computer and data analysis skills
  • Excellent verbal and written communication and presentation skills
  • Analytical Thinking: Ability to identify issues, obtain relevant information, relate and compare data from different sources and identify alternative solutions
  • Attention to detail: Achieve thoroughness and accuracy when accomplishing a task
  • Critical Thinking: Gathers and integrates critical information, recognizing and addressing underlying assumptions of others to arrive at effective solutions
  • Medical Staff Relations: Builds effective partnerships with medical staff, physicians, fostering open lines of communications and establishing trust
  • Problem Solving: Identifies problems, determines accuracy and relevance of information, utilizes appropriate tools and staff resources along with sound judgment to generate and evaluate alternatives and to make recommendations
  • Written Communication: Ability to organize and express information and ideas in written form to individuals as well as groups. Constructs messages that are clear and convincing

Preferred Qualifications
  • Bachelors Degree in Nursing for candidate's with nursing experience
  • 5 years acute care nursing or
  • 5 years inpatient coding experience
  • Certified Clinical Documentation Specialist (CCDS) for candidate's with HIM experience American Health Information Management Association Upon Hire

Benefit Overview
Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link foradditional information: https://www.fairview.org/careers/benefits/noncontract
Compensation Disclaimer
The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored.
EEO Statement
EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

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About Fairview Health Services

Sourced by ZipRecruiter

Fairview Health Services is an industry-leading, award-winning nonprofit that offers an entire network of healthcare services. Fairview is one part of M Health Fairview, a partnership between the University of Minnesota, M Physicians and Fairview Health Services. Together, we combine the University's deep history of clinical innovation and training with Fairview's extensive roots in community medicine. Our care portfolio includes community hospitals, academic hospitals, primary and specialty care clinics, senior facilities, facilitated living centers, rehabilitation centers, home health care services, counseling, pharmacies and benefit management services.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Minneapolis, MN, US

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