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Utilization Review Assistant Jobs in Fall River, MA

Brownhealth

Social Worker BSW

Riverside, RI · On-site

$50K - $83K/yr

... order to assist in resolving identified issues.Develops a service plan and provides services to ... For Coordinator positions involving utilization review activities, experience with managed care ...

Brown University Health

Social Worker BSW

Providence, RI · On-site

$50K - $83K/yr

... order to assist in resolving identified issues. Develops a service plan and provides services to ... For Coordinator positions involving utilization review activities, experience with managed care ...

Brownhealth

SAH Social Worker BSW PD

Fall River, MA · On-site

$24.29 - $40.07/hr

... to assist in resolving identified issues. * Develops a service plan and provides services to ... For Coordinator positions involving utilization review activities, experience with managed care ...

Brown University Health

Social Worker BSW

Providence, RI · On-site

$50K - $83K/yr

... order to assist in resolving identified issues. Develops a service plan and provides services to ... For Coordinator positions involving utilization review activities, experience with managed care ...

Brownhealth

Social Worker BSW

Providence, RI · On-site

$50K - $83K/yr

... to assist in resolving identified issues. * Develops a service plan and provides services to ... For Coordinator positions involving utilization review activities, experience with managed care ...

AMIVIE

Registered Nurse, Sign-on bonus!

Woonsocket, RI · On-site

Participate on an assigned advisory board or utilization review committee. * Review all client ... Secure/coordinate equipment and supplies for the client as needed in the home * Assist staff in ...

AMIVIE

Registered Nurse, RN

Lincoln, RI · On-site

Participate on an assigned advisory board or utilization review committee. * Review all client ... Secure/coordinate equipment and supplies for the client as needed in the home * Assist staff in ...

Brownhealth

SAH Social Worker BSW PD

Fall River, MA · On-site

$24.29 - $40.07/hr

... order to assist in resolving identified issues. Develops a service plan and provides services to ... For Coordinator positions involving utilization review activities, experience with managed care ...

Bcbsri

Case Mgr - Beh Health

Providence, RI · On-site +1

$73K - $110K/yr

We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental ... Collaborate with the Utilization Review process including pre-authorization, concurrent review ...

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All JobsUtilization Review JobsUtilization Review Assistant JobsUtilization Review Assistant Jobs in Fall River, MA

Utilization Review Assistant information

What is a utilization review assistant?

A Utilization Review Assistant supports the utilization review process by reviewing medical records, verifying insurance coverage, and ensuring that healthcare services meet necessary guidelines. They assist in gathering documentation, communicating with insurance providers, and coordinating with medical staff to facilitate approvals for treatments. Their role helps ensure that healthcare services are provided efficiently while maintaining compliance with insurance policies and regulations.

What skills and qualifications are needed to be a utilization review assistant?

To thrive as a Utilization Review Assistant, you need attention to detail, basic understanding of medical terminology, strong organizational skills, and typically a high school diploma or equivalent. Familiarity with healthcare management software and electronic health records (EHR) systems, along with experience in data entry, is important for this role. Strong communication, problem-solving abilities, and a customer service-oriented attitude help you excel when interacting with clinical staff and patients. These skills are essential for ensuring accurate review processes, compliance with regulations, and effective coordination within healthcare teams.

What does a utilization review assistant do?

A Utilization Review Assistant typically spends their day reviewing medical records, verifying patient information, and ensuring documentation meets insurance or regulatory requirements. They often work closely with nurses, physicians, case managers, and billing staff to collect necessary data and clarify documentation. The work is usually performed in an office within a hospital, clinic, or insurance company, where prioritizing tasks and maintaining confidentiality are key. This collaborative, detail-oriented environment provides a valuable introduction to healthcare administration and can open doors to broader roles in utilization management or case management.

What are popular job titles related to Utilization Review Assistant jobs in Fall River, MA? For Utilization Review Assistant jobs in Fall River, MA, the most frequently searched job titles are:
What cities near Fall River, MA are hiring for Utilization Review Assistant jobs? Cities near Fall River, MA with the most Utilization Review Assistant job openings:
Utilization Review Assistant jobs near you
Infographic showing various Utilization Review Assistant job openings in Fall River, MA as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution.

Social Worker BSW

Brownhealth

Riverside, RI • On-site

$50K - $83K/yr

Full-time

Re-posted 3 days ago

Job description

SUMMARY:Under the supervision of a Clinical Social Work Manager, or the designated Social Worker BSW, assists patients and families in resolving broad, medically related problems by locating and coordinating appropriate personal, hospital, community and financial resources, within a specialty service area.Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:Instill Trust and Value DifferencesPatient and Community Focus and CollaborateRESPONSIBILITIES:Interviews patients and families to obtain pertinent information concerning patient and family needs in the context of family functioning.Provides patient and family information to appropriate hospital personnel and community agencies in order to assist in resolving identified issues.Develops a service plan and provides services to patient and family in accordance with the service plan.Maintains appropriate documentation and statistics regarding case activity. May participate in departmental studies and projects to include planning and coordinating activities.Maintains list of hospital and community services and resources. Maintains and enhances professional expertise through appropriate educational activities as necessary.Assists in the resolution of practical problems of daily living and other concrete services, including transportation, housing, education and training, etc.Arranges and coordinates connective referrals to appropriate community agencies and programs.Functions for Social Work Coordinators who work in psychiatry or other specialty areas may also include: With the health care team, planning and executing discharge plans, including coordination of placement in a variety of settings.Conducts activities related to Utilization Management, including, securing authorizations, concurrent reviews to ensure payment for hospitalization.Works closely with treating physician to address insurance denials and participates in denial process.MINIMUM QUALIFICATIONS:BASIC KNOWLEDGE:Bachelors Degree in Social Work from a school accredited by the American Council on Social Work Education.A Bachelor's degree in a related field may be considered when accompanied by at least one year of relevant experience in managed care activities. Demonstrated knowledge and skills necessary to provide care patients with consideration of aging processes, human development stages and cultural patterns in each step of the care process. EXPERIENCE:One year professional experience working in health care setting or human service agency preferred.For Coordinator positions involving utilization review activities, experience with managed care desirable.Knowledge of health care and health care delivery systems.Analytical skills necessary to evaluate patients' concrete needs and to formulate and implement a treatment plan.SUPERVISORY RESPONSIBILITY: None

Pay Range:

$50,523.20-$83,345.60

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

Bradley Hospital - 1011 Veterans Memorial Pkwy East Providence, Rhode Island 02915

Work Type:

Monday - Friday days

Work Shift:

Day

Daily Hours:

8 hours

Driving Required:

No

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