PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Utilization Specialist
Burns, TN · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Utilization Specialist
Burns, TN · On-site
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
The Utilization Management Coordinator monitor appropriate utilization of services throughout the ... The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge ...
Conducts prospective, concurrent, and retrospective utilization reviews for medical necessity to ensure treatment and services are appropriate and necessary by reviewing medical records and treatment ...
Conducts prospective, concurrent, and retrospective utilization reviews for medical necessity to ensure treatment and services are appropriate and necessary by reviewing medical records and treatment ...
Conducts prospective, concurrent, and retrospective utilization reviews for medical necessity to ensure treatment and services are appropriate and necessary by reviewing medical records and treatment ...
Conducts prospective, concurrent, and retrospective utilization reviews for medical necessity to ensure treatment and services are appropriate and necessary by reviewing medical records and treatment ...
UR Coordinator - Full-time
Memphis, TN · On-site
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital . The UM Coordinator facilitates physician weekly staffing meetings and ...
UR Coordinator - Full-time
Memphis, TN · On-site
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital . The UM Coordinator facilitates physician weekly staffing meetings and ...
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UM Coordinator facilitates physician weekly staffing meetings and ...
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UM Coordinator facilitates physician weekly staffing meetings and ...
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UM Coordinator facilitates physician weekly staffing meetings and ...
Oversees utilization review activities with other departments to ensure reimbursement for services provided by the hospital. The UM Coordinator facilitates physician weekly staffing meetings and ...
CDI Specialist
Franklin, TN · Remote
$33.50 - $45/hr
Occasional weekend coverage may be required based on client needs Position Summary The CDI ... The CDI Specialist will work collaboratively with HIM, Coding, Case Management, Utilization Review ...
CDI Specialist
Franklin, TN · Remote
$33.50 - $45/hr
Occasional weekend coverage may be required based on client needs Position Summary The CDI ... The CDI Specialist will work collaboratively with HIM, Coding, Case Management, Utilization Review ...
Weekends: 1 Weekend Per Month of on-site rounding Compensation Details : * Competitive Compensation ... On-Site Case Management and Utilization Review * Recreational activities * Pharmacology * Family ...
Weekends: 1 Weekend Per Month of on-site rounding Compensation Details : * Competitive Compensation ... On-Site Case Management and Utilization Review * Recreational activities * Pharmacology * Family ...
Weekends: 1 Weekend Per Month of on-site rounding Compensation Details : * Competitive Compensation ... On-Site Case Management and Utilization Review * Recreational activities * Pharmacology * Family ...
Weekends: 1 Weekend Per Month of on-site rounding Compensation Details : * Competitive Compensation ... On-Site Case Management and Utilization Review * Recreational activities * Pharmacology * Family ...
Care Management Case Manager
Jackson, TN · On-site
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an ...
Care Management Case Manager
Jackson, TN · On-site
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an ...
Care Management Case Managers
Martin, TN · On-site
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an ...
Care Management Case Managers
Martin, TN · On-site
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an ...
Weekend Utilization Review information
See Tennessee salary details
$19.42 - $23.35
2% of jobs
$23.35 - $27.27
9% of jobs
$29.96 is the 25th percentile. Wages below this are outliers.
$27.27 - $31.20
21% of jobs
The median wage is $34.38 / hr.
$31.20 - $35.13
23% of jobs
$35.13 - $39.05
13% of jobs
$42.11 is the 75th percentile. Wages above this are outliers.
$39.05 - $42.98
10% of jobs
$42.98 - $46.91
8% of jobs
$46.91 - $50.84
5% of jobs
$50.84 - $54.76
5% of jobs
$54.76 - $58.69
2% of jobs
$58.69 - $62.62
2% of jobs
$19
$38
$62
How much do weekend utilization review jobs pay per hour?
What does a typical weekend shift look like for a Utilization Review professional?
Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.
What is a Weekend Utilization Review job?
A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.
What are the key skills and qualifications needed to thrive in the Weekend Utilization Review position, and why are they important?
Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.
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Part-time
Re-posted 13 days ago
Acadia Healthcare rating
6.2
Based on 189 frontline employees who took The Breakroom Quiz
699th of 886 rated healthcare providers
Job description
PURPOSE STATEMENT:
Proactively monitor utilization of services for patients to optimize reimbursement for the facility.
ESSENTIAL FUNCTIONS:
- Act as liaison between managed care organizations and the facility professional clinical staff.
- Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements.
- Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.
- Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office.
- Conduct quality reviews for medical necessity and services provided.
- Facilitate peer review calls between facility and external organizations.
- Initiate and complete the formal appeal process for denied admissions or continued stay.
- Assist the admissions department with pre-certifications of care.
- Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates.
OTHER FUNCTIONS:
- Perform other functions and tasks as assigned.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- Required Education: High school diploma or equivalent.
- Preferred Education: Associate's, Bachelor's, or Master’s degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field.
- Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred
LICENSES/DESIGNATIONS/CERTIFICATIONS:
- Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services.
- CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.
- First aid may be required based on state or facility requirements.
ADDITIONAL REGULATORY REQUIREMENTS:
While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances
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About Acadia Healthcare
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Acadia Healthcare is a leading provider in the healthcare and hospital industry, based in Franklin, Tennessee, United States. The company is recognised for its commitment to creating a behavioural health network that provides accessible, high-quality treatment options for individuals suffering from mental health issues, addiction, eating disorders, and PTSD. Acadia Healthcare was founded in 2005, with the mission to create a world-class organization that sets the standard of excellence in the treatment of specialty behavioural health and addiction disorders.
Industry
Hospitals
Company size
10,000+ Employees
Headquarters location
Franklin, TN, US
Year founded
2005