Utilization Review Specialist - PACE

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    "ShortDescriptionStr": "The Utilization Management Coordinator will work collaboratively with multiple disciplines, both internal and external to the organization to help provide high quality and cost-effective health management care for patients. Responsibilities include the review and tracking of ED admissions, inpatient hospitalizations, ICF and SNF utilization and specialist appointment utilization in the form of standardized reports which will be generated by the analyst to inform our clinical leadership and health plan regarding utilization trends and potential interventions. This coordination will allow one to work with our interdisciplinary PACE teams, the Inpatient Case Management Coordinator and Providence Health Plan bringing useful insight for ways we can reduce unnecessary resource utilization.",
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    "ExternalDescriptionStr": "<p><strong>Schedule</strong>: Monday-Friday Day shift</p><p><span style=\"color: black; font-family: Verdana, sans-serif;\"><span lang=\"RU\" style=\"font-size: 9pt;\">The Utilization Management Coordinator will work collaboratively with multiple disciplines, both internal and external to the organization to help provide high quality and cost-effective health management care for patients. Responsibilities include the review and tracking of ED admissions, inpatient hospitalizations, ICF and SNF utilization and specialist appointment utilization in the form of standardized reports which will be generated by the analyst to inform our clinical leadership and health plan regarding utilization trends and potential interventions. This coordination will allow one to work with our interdisciplinary PACE teams, the Inpatient Case Management Coordinator and Providence Health Plan bringing useful insight for ways we can reduce unnecessary resource utilization.</span></span></p><p><span style=\"color: black; font-family: Verdana, sans-serif;\"><span lang=\"RU\" style=\"font-size: 9pt;\">Additional duties may include providing support around InterQual criteria for Inpatient Case Management Coordinators and Operations Managers. Development and updating key performance indicator reports for clinical and administrative staff. Assists the RN inpatient care management team to facility more efficient hospital discharges.&nbsp;</span></span></p><p>Providence PACE is a Program of All-Inclusive Care for the Elderly that strives to keep older adults as healthy as possible living in the community through clinics, home visits and more. Join our team to help empower elders in your community to live active, independent lives.</p><p><strong>Required Qualifications:</strong></p><ul><li>Bachelor's Degree</li><li>Experience with data collection and interpretation in the business or clinical setting, preferably within healthcare.&nbsp;</li></ul><p><strong>Preferred Qualifications:</strong></p><ul><li>Master's Degree OR Data Analyst, Business background, or related fields with skills set complimentary to this position and a data analytics background. &nbsp;&nbsp;&nbsp;&nbsp;</li><li>1-2 years' work experience doing utilization review in either a hospital, ambulatory care, health plan setting, or an equivalent field within data sciences.&nbsp;</li></ul><p><strong>Why Join Providence?&nbsp;</strong></p><p>Our&nbsp;<a href=\"https://nam11.safelinks.protection.outlook.com/?url=https://providence.jobs/benefits/&amp;data=05|01|[email protected]|6da11282629946c936bc08dbf64b1e78|2e3190869a2646a3865f615bed576786|0|0|638374574718197112|Unknown|TWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0=|3000|||&amp;sdata=CHUc7JRL0t6AAExYx6UfCEVEH8gfmaw9cEOZ4wX0+ZU=&amp;reserved=0\" target=\"_blank\" rel=\"nofollow\">best-in-class benefits</a>&nbsp;are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our&nbsp;<a href=\"https://providence.jobs/mission/\" target=\"_blank\" rel=\"nofollow\">Mission</a>&nbsp;of caring for everyone, especially the most vulnerable in our communities.</p><p>Accepting a new position at another facility that is part of the Providence family of organizations may change your current benefits. Changes in benefits, including paid time-off, happen for various reasons. These reasons can include changes of Legal Employer, FTE, Union, location, time-off plan policies, availability of health and welfare benefit plan offerings, and other various reasons. &nbsp;</p>",
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    "CorporateDescriptionStr": "<br/>\n<div>\n</div>\n<div>\n <div>\n  At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.\n </div>\n <div>\n  <br/>\n </div>\n <div>\n  Posted are the minimum and the maximum wage rates on the wage range for this position.&nbsp; The successful candidate's placement on the wage range for this position will be determined based upon relevant job experience and other applicable factors. These amounts are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.\n </div>\n <div>\n  <br/>\n </div>\n <div>\n  Providence offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, vision), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at&nbsp;<a href=\"https://providence.jobs/benefits/\" target=\"_blank\" rel=\"nofollow\">providence.jobs/benefits</a>.\n </div>\n <div>\n  <br/>\n </div>\n <div>\n  Applicants in the Unincorporated County of Los Angeles: Qualified applications with arrest or conviction records will be considered for employment in accordance with the&nbsp;<a href=\"https://s3-us-west-2.amazonaws.com/images.provhealth.org/HR-onboarding/LA_County_Fair_Chance_Ordinance_2024.pdf\" target=\"_blank\" rel=\"nofollow\">Unincorporated Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act</a>.\n </div>\n</div>",
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