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Chart Utilization Review Jobs in Nebraska (NOW HIRING)

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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 cities in Nebraska are hiring for Chart Utilization Review jobs?

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

Infographic showing various Chart Utilization Review job openings in Nebraska as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution.

Pharmacist - Omaha (Full Time Evenings, Mon-Fri)

Madonna Rehabilitation Hospital

Omaha, NE • On-site

$55.75 - $67/hr

Other

Posted 20 days ago


Madonna Rehabilitation Hospitals rating

8.2

Company rating: 8.2 out of 10

Based on 18 frontline employees who took The Breakroom Quiz

101st of 1,061 rated hospitals


Job description

***$15,000 SIGN ON BONUS*
*Evening Shift Differential Available***
**Job Title: Clinical/Staff Pharmacist
Job Code: 550039**
**Immediate Supervisor:** Pharmacy Manager or Pharmacy Operations Supervisor
**Status:** Exempt
**Shift:** 3-10 pm (35 hr/wk) OR1:30-10 pm(40 hr/wk)
**JOB OVERVIEW** * The Clinical/Staff pharmacist will provide dispensing, distributive, educational and clinical services to inpatients, hospital and medical staff. * This position will work closely with the Pharmacy Manager or Pharmacy Operations Supervisor and Clinical Pharmacy Coordinator to provide distributive and clinical pharmacy services. Review and interpret physician orders. * Accurately dispense medications with a minimum/decrease in number of discrepancy reports. Provide accurate and timely drug information. * Comply with all legal and practice standards. * Available as a resource for applicable student clerkship programs. * Review daily clinical reports such as antibiotics, IVs, LMWHs, etc., as requested. * Work will be performed in an ethical and legal manner following organizational policies, processes, protocols and procedures. * Responsible for quality service delivery and internal/external customer relations for Madonna as a whole, including upholding the mission and values for the department and facility.
**ESSENTIAL FUNCTIONS** 1. Incorporate the hospital mission into all tasks. 2. Maintain positive/professional communications with all hospital staff. 3. Provide accurate and useful drug therapy information and education to hospital staff including in service opportunities. Attend all pharmacy staff meetings and in services opportunities. 4. Participate in the distributive phase of pharmacy operations including dispensing or checking medications intended for inpatient use in a timely manner 5. Interpret physician orders accurately and assess for safety and appropriateness. 6. Enter and/or verify patient medication orders into the computer system accurately, ensuring that dosing is appropriate for patient age, weight, renal and hepatic function. 7. Review patient profiles for diagnosis, allergies, duplications, interactions, and renal function. 8. Prepare or check intravenous medications intended for inpatient administration. 9. Prepare and dispense parenteral nutrition fluids. 10. Prepare and dispense oral chemotherapy agents. 11. Compound medications or treatments which are not commercially available. 12. Maintain proper inventory levels/purchasing. 13. Maintain quality improvement program, Perform and document therapeutic interventions 14. Maintain/monitor narcotics and narcotic records. 15. Validate technician distributive activity (i.e. check technician work prior to dispensing) and act as a resource and mentor for technician questions. 16. Complete tasks described above while maintaining acceptable productivity. 17. Assist in the collection of patient specific information, monitoring of effects, identification of goals, and implementation of monitoring plan with patient and health care team. 18. Monitor inpatient drug regimens and participate in the intervention process to improve patient outcomes and promote intelligent use of medications. 19. Analyze patient charts and suggest drug therapy modifications based on the medical information and patient history contained in the chart. 20. Monitor patient medication therapies, with special emphasis on those identified by clinical pharmacy initiatives. 21. Participate in adverse drug reaction monitoring including utilization of national database documentation processes when applicable, alert the patient's prescriber and health team to potential problems caused by drug: drug interactions, compromised renal or hepatic function and other pre-existing conditions that may impact drug absorption, distribution, metabolism or excretion. 22. Participate in patient medication counseling and information collection. 23. Serve on hospital committees as requested. 24. Participate in community affairs that publicize the hospital's value to the community. 25. Comply with all local, state and federal rules, regulations and laws relating to the practice of pharmacy and comply with the requirements of accrediting bodies and Madonna Rehabilitation Hospital. 26. Demonstrate clinical proficiency in all areas while maintaining accountability for continually improving job knowledge and skills.
**PHYSICAL DEMANDS AND ENVIRONMENTAL CONDITIONS**
1. Lifting 25 pounds maximum with frequent lifting and/or carrying of objects weighing up to 25 pounds; climbing, balancing, stooping, kneeling, crouching, standing and walking. 2. Works in a climate-controlled environment. Hazards include potential for exposure to hazardous (cytotoxic, chemotherapy) materials which are stored and prepared in the department. 3. Critical Demands: High volume of work, pressure to provide emergency medications, constant interruptions, weekend/holiday/evening/on-call shifts may be required. 4. Aptitudes: Must have excellent learning abilities, verbal skills, manual dexterity and color discrimination; typing and/or word processor proficiency are helpful. 5. Requires sufficient sight to see and read reports and computer screen. Requires sufficient hearing and speaking to communicate by phone or in person.
**QUALIFICATIONS** (Education/Training and/or Experience)
A. Skills/Qualifications: 1. 1. Education and Training: Minimum degree: Pharm.D.; Must maintain continuing education as mandated by Nebraska law. 2. License: Must possess a current active license to practice Pharmacy in the State of Nebraska. 3. Experience: Hospital practice experience is preferred. 4. Judgment and Complexity: Sound professional judgment is required for skills that are technically sophisticated and intellectually challenging.
B. Responsibilities: 1. Accuracy and Effect of Errors: Serious error may have a profound effect on patient welfare and outcome. 2. Responsibility for Personal Contacts: Must be tactful and courteous in all professional and personal dealings. 3. Responsibility for Confidential Material and Information: Must maintain and respect patient and family privacy and confidentiality at all times.
Background checks are conducted. When specific authorization forms are requested so that full background and history can be obtained, employees/applicants must sign the form(s) requested.


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