Utilization Review Specialist - Henry Ford Macomb Hospital (Contingent - Days)
Requisition #: 90357
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
More information about this position
Overview:
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,100-member Henry Ford Medical Group, six hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2013, Henry Ford provided $314 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 23,000 employees. Henry Ford is a 2011 Malcolm Baldrige National Quality Award recipient. The health system is led by CEO Nancy Schlichting. To learn more, visit HenryFord.com
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.
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.
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.
Qualifications:
Previous experience with medical chart review along with interqual and insurance company reviews is preferred.
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 #: 90357
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
More information about this position
Overview:
Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health care systems, is a national leader in clinical care, research and education. The system includes the 1,100-member Henry Ford Medical Group, six hospitals, Health Alliance Plan (a health insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory network and many other health-related entities throughout southeast Michigan, providing a full continuum of care. In 2013, Henry Ford provided $314 million in uncompensated care. The health system also is a major economic driver in Michigan and employs more than 23,000 employees. Henry Ford is a 2011 Malcolm Baldrige National Quality Award recipient. The health system is led by CEO Nancy Schlichting. To learn more, visit HenryFord.com
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.
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.
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.
Qualifications:
Previous experience with medical chart review along with interqual and insurance company reviews is preferred.
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..