Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... Medical, Dental and Vision Insurance * Paid Time Off (vacation, holidays and sick days) and Medical ...
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... Medical, Dental and Vision Insurance * Paid Time Off (vacation, holidays and sick days) and Medical ...
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... Medical, Dental and Vision Insurance * Paid Time Off (vacation, holidays and sick days) and Medical ...
Mountain View Hospital is looking for a Utilization Review Coordinator to join our team! JOB ... Medical, Dental and Vision Insurance * Paid Time Off (vacation, holidays and sick days) and Medical ...
Medicaid Utilization Review Analyst - MED
Coeur D Alene, ID · On-site
$27.12 - $27.70/hr
Life insurance for self, spouse, and children * Short and long-term disability insurance * Flexible ... utilization patterns that may indicate program abuse. * Reviews claims data, medical records and ...
Medicaid Utilization Review Analyst - MED
Coeur D Alene, ID · On-site
$27.12 - $27.70/hr
Life insurance for self, spouse, and children * Short and long-term disability insurance * Flexible ... utilization patterns that may indicate program abuse. * Reviews claims data, medical records and ...
Perform concurrent review of members admitted to inpatient facilities, residential treatment ... Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Active ...
Perform concurrent review of members admitted to inpatient facilities, residential treatment ... Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Active ...
Perform concurrent review of members admitted to inpatient facilities, residential treatment ... Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Active ...
Perform concurrent review of members admitted to inpatient facilities, residential treatment ... Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Active ...
Perform concurrent review of members admitted to inpatient facilities, residential treatment ... Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Active ...
Perform concurrent review of members admitted to inpatient facilities, residential treatment ... Insurance industry experience helpful, but not required. Education, Certificates, Licenses: Active ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
... review, and regulatory compliance. May also be responsible for ensuring that medical payments are ... Familiarity with health insurance industry trends and technology. * Demonstrated competency related ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Clinical Resource Manager
Boise, ID · On-site
$61K - $85K/yr
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Clinical Resource Manager
Boise, ID · On-site
$61K - $85K/yr
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
Provides hospital case management/utilization review and discharge planning collaboratively ... Experience in case management, home health, and/or the insurance industry preferred. WHAT YOU WILL ...
... and utilization review. 100-mile radius rule, no local candidates 08:30-17:00 About LRS Health ... Life Insurance * 401(k) * Certification & License Reimbursement * Refer-a-friend Bonus Program
... and utilization review. 100-mile radius rule, no local candidates 08:30-17:00 About LRS Health ... Life Insurance * 401(k) * Certification & License Reimbursement * Refer-a-friend Bonus Program
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Boise, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Boise, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Coeur D Alene, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Coeur D Alene, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Pocatello, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Pocatello, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Lewiston, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Associate Medical Director Behavioral Health or Utilization Management Medical Director DOE
Lewiston, ID · Remote
Conducts case reviews requiring physician involvement and/or provides clinical expertise to others ... Knowledge of the health insurance industry, state and federal regulations (including Parity ...
Travel Nurse RN - Case Management - $2,412 per week
Pocatello, ID · On-site
$2.4K/wk
... and utilization review. 100-mile radius rule, no local candidates 08:30-17:00 About LRS Health ... Life Insurance * 401(k) * Certification & License Reimbursement * Refer-a-friend Bonus Program
Travel Nurse RN - Case Management - $2,412 per week
Pocatello, ID · On-site
$2.4K/wk
... and utilization review. 100-mile radius rule, no local candidates 08:30-17:00 About LRS Health ... Life Insurance * 401(k) * Certification & License Reimbursement * Refer-a-friend Bonus Program
Insurance Utilization Review information
See Idaho salary details
$20.13 - $24.20
2% of jobs
$24.20 - $28.27
9% of jobs
$31.06 is the 25th percentile. Wages below this are outliers.
$28.27 - $32.34
21% of jobs
The median wage is $35.64 / hr.
$32.34 - $36.41
23% of jobs
$36.41 - $40.49
13% of jobs
$43.65 is the 75th percentile. Wages above this are outliers.
$40.49 - $44.56
10% of jobs
$44.56 - $48.63
8% of jobs
$48.63 - $52.70
5% of jobs
$52.70 - $56.77
5% of jobs
$56.77 - $60.84
2% of jobs
$60.84 - $64.91
2% of jobs
$20
$39
$64
How much do insurance utilization review jobs pay per hour?
What are the most common challenges faced by Insurance Utilization Review professionals?
One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.
What are the key skills and qualifications needed to thrive in the Insurance Utilization Review position, and why are they important?
To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.
What is an Insurance Utilization Review job?
An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.
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Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted yesterday
Mountain View Hospital (Idaho Falls) rating
5.2
Based on 59 frontline employees who took The Breakroom Quiz
964th of 1,051 rated hospitals
Job description
JOB SUMMARY: As a member of the Utilization Management Team, the UR
Coordinator helps establish and maintain efficient methods of ensuring the medical necessity and appropriateness of hospital admissions and extended stays. The Utilization Management Team directs the program in accordance with Mountain View Hospital's mission and strategic goals. The Utilization Management Team directs those activities within the facility which monitor adherence to the hospital's utilization review plan. The goal of Utilization Management is to continuously improve effective use of hospital services through monitoring patient admissions and stays.
About Mountain View:
Mountain View Hospital and our 29 affiliate clinics are committed to providing compassionate, cutting edge care to our patients. We serve the entire Snake River Valley - all the way from Pocatello to Rexburg. Our medical capabilities span everything from wound care to urgent care, oncology to neurology, physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a continuously expanding rural health practice.
Our work environment is mission driven, people-centric and supportive. It is what sets apart and makes people excited to come to work each day. If you are looking for a career where you can make a difference in your community, we invite you to apply.
BENEFITS:
Taking care for our community starts with taking care of our own team. Mountain View Hospital is proud to offer its employees competitive and comprehensive benefit packages. Benefits include:
- Medical, Dental and Vision Insurance
- Paid Time Off (vacation, holidays and sick days) and Medical Paid Time Off
- Retirement Plans (401K with up to 6% match)
- Earned Quarterly Bonus Program
- Education Reimbursement Program
- Discount for medically necessary procedures performed at Mountain View Hospital and Idaho Falls Community Hospital
Please note benefits are based on eligibility according to full-time, part-time or PRN status classification.
Education/Certification: High School Diploma or equivalent. Coding certificate completion is required within 1 year of employment
Experience: Background in medical terminology is helpful. Medical coding and/or insurance experience preferred, however coding certification will be required with in one calendar year of employment
What Mountain View Hospital (Idaho Falls) employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Mountain View Hospital
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
1,001 - 5,000 Employees
Headquarters location
Idaho Falls, ID, US
Year founded
2002