Participate in quality improvement initiatives, including sentinel event reviews and chart audits. * Engage actively in the Utilization Review process, ensuring appropriate use of healthcare ...
Participate in quality improvement initiatives, including sentinel event reviews and chart audits. * Engage actively in the Utilization Review process, ensuring appropriate use of healthcare ...
Participate in quality improvement initiatives, including sentinel event reviews and chart audits. * Engage actively in the Utilization Review process, ensuring appropriate use of healthcare ...
Participate in quality improvement initiatives, including sentinel event reviews and chart audits. * Engage actively in the Utilization Review process, ensuring appropriate use of healthcare ...
Medical Compliance Auditor
Bellaire, TX · On-site
This process includes clinical judgment, utilization review, application of product benefits ... Completes timely entry of information into electronic file including a chart with detailed findings ...
Medical Compliance Auditor
Bellaire, TX · On-site
This process includes clinical judgment, utilization review, application of product benefits ... Completes timely entry of information into electronic file including a chart with detailed findings ...
... collected (chart audits, DEYTA reports, infection control, complaints, utilization review etc.), prepare reports and make recommendations based on studies and reports. * Conduct educational ...
Quick apply
... collected (chart audits, DEYTA reports, infection control, complaints, utilization review etc.), prepare reports and make recommendations based on studies and reports. * Conduct educational ...
Perform routine chart audits and clinical documentation review to identify correct level of care ... utilization review, clinical review, and authorizations • Knowledge of CMS Medicare Part A, B ...
Perform routine chart audits and clinical documentation review to identify correct level of care ... utilization review, clinical review, and authorizations • Knowledge of CMS Medicare Part A, B ...
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... Three to Five years experience in insurance, utilization review or case management preferred.
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... insurance, utilization review or case management preferred. Requires the ability to work ...
Receives referrals and arranges evaluations; reviews chart; obtains financial information as ... insurance, utilization review or case management preferred. Requires the ability to work ...
This process includes clinical judgment, utilization review, application of product benefits ... chart with detailed findings of the review and a report summarizing the results of the audit. • ...
This process includes clinical judgment, utilization review, application of product benefits ... chart with detailed findings of the review and a report summarizing the results of the audit. • ...
Medical Compliance Auditor
Bellaire, TX · On-site
This process includes clinical judgment, utilization review, application of product benefits ... chart with detailed findings of the review and a report summarizing the results of the audit. • ...
Medical Compliance Auditor
Bellaire, TX · On-site
This process includes clinical judgment, utilization review, application of product benefits ... chart with detailed findings of the review and a report summarizing the results of the audit. • ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Team Manager Inpatient
Dallas, TX · On-site
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Team Manager Inpatient
Dallas, TX · On-site
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Performs substantive chart reviews to assure there is evidence that quality care is being delivered. * Participates in the Outcomes Management and annual program review. * Performs utilization review ...
Medical Assistant- OB/GYN Medical Center Associates
Houston, TX · On-site
$17 - $21.75/hr
Put charges and diagnoses on chart forms or obtain this from the physician. * Instruct the patient ... Notify Utilization Review for verification and "Surgery Notification", CC to Financial Review; pre ...
Medical Assistant- OB/GYN Medical Center Associates
Houston, TX · On-site
$17 - $21.75/hr
Put charges and diagnoses on chart forms or obtain this from the physician. * Instruct the patient ... Notify Utilization Review for verification and "Surgery Notification", CC to Financial Review; pre ...
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?
What is chart utilization review?
What are some common challenges faced by professionals in chart utilization review, and how can they be addressed?
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.
- Flexible Cvs Utilization Management Nurse
- Part Time Utilization Review Nurse
- Remote Per Diem Utilization Review Nurse
- Evening Utilization Review Nurse
- Per Diem Utilization Review Nurse
- Weekend Physician Advisor Utilization Review
- Remote Utilization Management Nurse
- Remote Medical Review Nurse
- Manager Utilization Management
- Overnight Utilization Review Nurse
- Medical Claims Review Nurse
- Utilization Review Case Manager
- Online Utilization Review
- Insurance Utilization Review
- Utilization Review Nurse Compact License
- Night Shift Optum Utilization Review
- Remote Occupational Therapy Utilization Review
- Weekend Utilization Review
- Remote Hca Utilization Review
- Overnight Remote Utilization Review

Other
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 5 days ago
YesCare rating
6.7
Based on 20 frontline employees who took The Breakroom Quiz
Job description
Join YesCare: A Career with Purpose in Correctional Healthcare
Correctional healthcare is more than just a job—it’s a calling. At YesCare, you have the unique opportunity to make a meaningful difference in the health, well-being, and future of an underserved population.
As a pioneer in correctional healthcare services, YesCare is committed to innovation, clinical expertise, and compassionate care. By choosing a career with YesCare, you are opting for professional growth, impactful work, and the chance to be part of a legacy of excellence. You’ll have access to the resources, training, and support needed to enhance your skills and reach your full career potential. Your role at YesCare allows you to contribute directly to the care and well-being of patients who need it most. Join a team that’s known for its innovative approaches and dedication to improving correctional healthcare.
Make a difference where it matters most. Start your journey with YesCare today and be part of a team that is transforming lives through care and expertise.
Key Responsibilities
- Administrative Duties:
- Chair the Medical Audit Committee, ensuring quality standards are upheld.
- Consult with community medical providers to address and resolve patient care issues.
- Supervise clinical services provided by professional and paraprofessional staff.
- Provide and ensure on-call services to support patient care needs.
- Review and approve clinical protocols, policies, procedures, and the medical disaster plan annually.
- Lead quality improvement initiatives, including patient complaints, infection control, peer review, and chart audits.
- Oversee referrals to external healthcare facilities, ensuring appropriateness, quality, and continuity of care.
- Serve as a resource and leader for all clinical staff, fostering collaboration and excellence.
- Participate in screening, interviewing, credential evaluation, and hiring of healthcare providers.
- Represent the healthcare program in discussions with civic groups or officials as needed.
- Maintain timely, legible, and signed documentation of patient encounters in medical records.
- Clinical Duties:
- Deliver evidence-based care, including sick call, chronic care, history and physicals, and emergency care.
- Conduct daily infirmary visits and document encounters as assigned.
- Provide on-call services as needed, ensuring continuity of care.
- Adhere to the approved formulary and document requests for non-formulary medications as necessary.
- Utilize in-house resources to address patient issues before off-site referrals.
- Demonstrate proficiency in cardiopulmonary resuscitation (CPR) and Automated External Defibrillator (AED) use, maintaining required certifications.
- Lead medical staff meetings and provide monthly in-service education for staff.
- Participate in quality improvement initiatives, including sentinel event reviews and chart audits.
- Engage actively in the Utilization Review process, ensuring appropriate use of healthcare resources.
Key Qualifications
- Medical Education: Graduate of an accredited medical school.
- Licensure: Fully licensed to practice medicine in the state of employment.
- DEA Registration: Active and current registration.
- Board Certification:
- Preferred: Board-certified or board-eligible in primary care specialties, including Family Practice, Internal Medicine, Emergency Medicine, Public Health, or Occupational Medicine.
- Administrative Experience:
- Experience in corrections and/or managed healthcare delivery is highly desirable.
- Additional Requirements:
- Must successfully pass a background check, security clearance, and drug screening.
YesCare Benefits (For Full-Time Positions)
- Health, Dental, and Vision Insurance
- Life and Disability Insurance
- Generous PTO Plan
- 401k with Matching Funds
- Employee Discount and Rewards Program
- Tuition Assistance
- Continuing Education Reimbursement
Why Join YesCare?
YesCare provides a supportive and structured environment where you can thrive in a leadership role while delivering meaningful healthcare in a correctional setting. Your expertise and leadership will directly impact the quality of care and operations within our facilities.
Equal Opportunity Employer Statement
YesCare is an Equal Opportunity/Affirmative Action Employer . We comply with all federal and state employment opportunity laws and consider qualified applicants without regard to race, gender, national origin, religion, age, sexual orientation, disability, or veteran status.
Category: Physician
About YesCare
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Brentwood, TN, US
Year founded
1978