Utilization Review Specialist
Requisition #: 78880
Status: Contingent
Business Unit: HF Macomb Clinton Twp
Shift: Days
Department: Case Management - HFMH
Weekends: No
Job Family: Quality/Utilization Review
Job Function: Admin Support (Non-clinical)
Campus/Job Location Henry Ford Macomb Hospital - Clinton Township
Location (State/City): US-MI-Clinton Township
Overview
Our health system thrives on teamwork, and we know our employees achieve the greatest results when they are working together for a common goal - to provide care for our patients. If you enjoy working in a collaborative environment then we have a job for you!
Henry Ford Health System is one of the country's largest health care systems and a national leader in clinical care, research and education. Our system includes the 1,200-member Henry Ford Medical Group, six hospitals, Health Alliance Plan, 32 primary care centers and many other health-related entities throughout Southeast Michigan. Founded in 1915 by auto pioneer Henry Ford, we continue to be committed to improving the health and well-being of a diverse Michigan community. In 2009 alone, Henry Ford Health System provided more than $173 million in uncompensated care. Henry Ford also is a major economic driver in Michigan and employs more than 23,000. Our health system is led by CEO Nancy Schlichting.
Responsibilities
Under limited direction and in accordance with established policies, procedures, guidelines and criteria, regularly exercises clinical judgment in the review and assessment of patients' records. Reviews care and treatment received. Communicates with third party payers in order to obtain authorization for care. Acts as a resource to related parties by providing training and educational sessions.
Qualifications
EDUCATION AND EXPERIENCE:
- Associate's Degree in Nursing (ADN), Licensed Practical Nurse (LPN), Bachelor's Degree in Social Work, or Registered Health Information Technician (RHIT).
- Registration Health Information Administrator (RHIA), preferred.
- Minimum of five years of progressively more responsibility.
ADDENDUM:
- Henry Ford Macomb-Behavioral Health departments: Experience: 2-5 years behavioral health specific. Education: In addition to above, also acceptable Associate or Bachelor's in a related field (i.e., Psychology) preferred with required behavioral health experience.
WORKING CONDITIONS:
- Works in a normal patient care environment with little exposure to noise, dust, temperature and the like.
- Occasional exposure to communicable diseases and infection when working with patients.
Equal Employment Opportunity / Affirmative Action Employer
Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, age, disability, religion, weight/height, marital status, familial status, veteran status or any other characteristic protected by law.
Requisition #: 78880
Status: Contingent
Business Unit: HF Macomb Clinton Twp
Shift: Days
Department: Case Management - HFMH
Weekends: No
Job Family: Quality/Utilization Review
Job Function: Admin Support (Non-clinical)
Campus/Job Location Henry Ford Macomb Hospital - Clinton Township
Location (State/City): US-MI-Clinton Township
Overview
Our health system thrives on teamwork, and we know our employees achieve the greatest results when they are working together for a common goal - to provide care for our patients. If you enjoy working in a collaborative environment then we have a job for you!
Henry Ford Health System is one of the country's largest health care systems and a national leader in clinical care, research and education. Our system includes the 1,200-member Henry Ford Medical Group, six hospitals, Health Alliance Plan, 32 primary care centers and many other health-related entities throughout Southeast Michigan. Founded in 1915 by auto pioneer Henry Ford, we continue to be committed to improving the health and well-being of a diverse Michigan community. In 2009 alone, Henry Ford Health System provided more than $173 million in uncompensated care. Henry Ford also is a major economic driver in Michigan and employs more than 23,000. Our health system is led by CEO Nancy Schlichting.
Responsibilities
Under limited direction and in accordance with established policies, procedures, guidelines and criteria, regularly exercises clinical judgment in the review and assessment of patients' records. Reviews care and treatment received. Communicates with third party payers in order to obtain authorization for care. Acts as a resource to related parties by providing training and educational sessions.
Qualifications
EDUCATION AND EXPERIENCE:
- Associate's Degree in Nursing (ADN), Licensed Practical Nurse (LPN), Bachelor's Degree in Social Work, or Registered Health Information Technician (RHIT).
- Registration Health Information Administrator (RHIA), preferred.
- Minimum of five years of progressively more responsibility.
ADDENDUM:
- Henry Ford Macomb-Behavioral Health departments: Experience: 2-5 years behavioral health specific. Education: In addition to above, also acceptable Associate or Bachelor's in a related field (i.e., Psychology) preferred with required behavioral health experience.
WORKING CONDITIONS:
- Works in a normal patient care environment with little exposure to noise, dust, temperature and the like.
- Occasional exposure to communicable diseases and infection when working with patients.
Equal Employment Opportunity / Affirmative Action Employer
Henry Ford Health System is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, national origin, sex, sexual orientation, age, disability, religion, weight/height, marital status, familial status, veteran status or any other characteristic protected by law.