Utilization Review Coordinator at Cedars-Sinai Medical Center, Portland, Oregon

Company Overview: Cedars-Sinai Medical Center is a renowned healthcare institution dedicated to providing exceptional patient care, conducting innovative research, and educating the next generation of healthcare professionals. As a leader in the industry, Cedars-Sinai is committed to delivering world-class medical services and improving the well-being of individuals in Portland, Oregon, and beyond. Key Responsibilities for Utilization Review Coordinator: - Conduct comprehensive reviews of patient medical records to ensure compliance with regulatory requirements and optimize patient care outcomes. - Collaborate with healthcare providers to assess the appropriateness of treatment plans and utilization of resources. - Analyze data and trends to identify opportunities for quality improvement and cost-effective practices. - Communicate with insurance providers to facilitate authorization for necessary medical services. - Participate in multidisciplinary team meetings to discuss patient cases and contribute to care coordination efforts. Required Qualifications: - Bachelor's degree in Nursing, Healthcare Administration, or related field. - Minimum of 2 years of experience in utilization review or a similar role within a healthcare setting. - Strong understanding of healthcare regulations, including Medicare and Medicaid guidelines. - Excellent analytical skills with the ability to interpret complex medical information. - Proficient in utilizing electronic health records (EHR) systems and Microsoft Office applications. - Exceptional communication and interpersonal skills to effectively engage with diverse stakeholders. Desired Skills: - Certification in Utilization Review (UR) or Case Management. - Knowledge of ICD-10 coding and medical terminology. - Experience working with InterQual or Milliman criteria. - Ability to work independently and prioritize tasks in a fast-paced environment. - Understanding of value-based care models and population health management. Compensation & Benefits: The annual salary range for the Utilization Review Coordinator position at Cedars-Sinai Medical Center in Portland, Oregon, is competitive and commensurate with experience. In addition to competitive pay, employees receive a comprehensive benefits package, including medical, dental, and vision coverage, retirement savings plans, paid time off, and professional development opportunities. How to Apply: To apply for the Utilization Review Coordinator role at Cedars-Sinai Medical Center, please submit your resume and a cover letter highlighting your relevant experience and qualifications via our online career portal. We appreciate your interest in joining our dynamic team and contributing to our mission of providing exceptional healthcare services.