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Free Utilization Review Training Jobs in Kansas (NOW HIRING)

Evolent

Physician Reviewer-Radiology (Part Time)

Topeka, KS · On-site

$95 - $100/hr

... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... Participates in on-going training per inter-rater reliability process. Qualifications: * MD/DO/MBBS

Erickson

Clinical Manager, RN

Overland Park, KS · On-site

$100K/yr

Free access to our on-site Team member Health and Well-Being Centers, plus Well-Being programs ... Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee

Erickson Living

Clinical Manager, RN

Overland Park, KS · On-site

$100K/yr

Free access to our on-site Team member Health and Well-Being Centers, plus Well-Being programs ... Utilization Review, and Performance Improvement/Risk Management/Safety (PI/RM/S) Committee

Wellpath

Medical Director

Kansas City, KS

$66K - $73K/yr

Growth and training Perks and Benefits In addition to comprehensive benefits including medical ... Oversee chronic care clinics, utilization review, and quality improvement initiatives * Collaborate ...

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Free Utilization Review Training information

What is free utilization review training?

Free utilization review training refers to educational programs or courses that teach individuals the fundamentals of utilization review without requiring payment. Utilization review is a process used in healthcare to assess the necessity, efficiency, and appropriateness of medical services, procedures, or admissions. These free training options are often available online and can help nurses, case managers, or other healthcare professionals gain the skills needed to pursue roles in utilization management. Training typically covers topics such as clinical guidelines, insurance protocols, and regulatory compliance. Completing such training can enhance career opportunities in healthcare case management and insurance settings.

What are the key skills and qualifications needed to thrive as a utilization review nurse, and why are they important?

To thrive as a Utilization Review Nurse, you need a current RN license, strong clinical assessment skills, and knowledge of insurance and healthcare regulations. Familiarity with utilization management software, electronic health records (EHRs), and possibly certifications like Certified Utilization Review Nurse (CURN) are typically expected. Excellent communication, analytical thinking, and attention to detail are standout soft skills in this position. These abilities are crucial for ensuring appropriate patient care, compliance, and cost-effective healthcare delivery.

What are some common challenges faced by professionals during utilization review training, and how can they be overcome?

During utilization review training, professionals often encounter challenges such as adapting to complex healthcare regulations, learning to interpret medical records efficiently, and effectively applying clinical guidelines to decision-making. Overcoming these challenges requires strong attention to detail, ongoing engagement with training modules, and seeking mentorship from experienced utilization review nurses or case managers. Actively participating in case discussions and staying updated with industry standards can also help trainees build confidence and competence for a successful career in utilization review.

What is the difference between Free Utilization Review Training vs Utilization Review Nurse?

AspectFree Utilization Review TrainingUtilization Review Nurse
CredentialsTypically no formal credentials required; focus on training programsRegistered Nurse (RN) license required, with possible certifications like CCM or UR-specific credentials
Work EnvironmentTraining sessions, online courses, workshopsHospitals, insurance companies, healthcare facilities
Employer & Industry UsageUsed for skill development and certification prepPerforming reviews, making coverage decisions, ensuring appropriate care

Free Utilization Review Training provides foundational knowledge and skills for those interested in entering or advancing in utilization review roles. In contrast, a Utilization Review Nurse is a licensed healthcare professional actively performing review duties in clinical settings. The training is often a prerequisite or supplement to the nurse's practical work, which requires licensure and clinical experience.

How to become a free utilization review training?

To pursue free utilization review training, individuals can seek online courses, webinars, or workshops offered by healthcare organizations or professional associations. Gaining knowledge of medical terminology, insurance processes, and review protocols is essential, and some programs may require prior healthcare experience or certification in related fields.

What are popular job titles related to Free Utilization Review Training jobs in Kansas?

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

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

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

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Cities in Kansas with the most Free Utilization Review Training job openings:

Free Utilization Review Training jobs near you

Utilization Reviewer

Bert Nash Community Mental Health Center

Lawrence, KS • On-site

$65K - $70K/yr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Bert Nash Community Mental Health Center rating

6.2

Company rating: 6.2 out of 10

Based on 8 frontline employees who took The Breakroom Quiz

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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