Utilization Review Analyst – Utilization Management – Part Time – Woman’s Hospital – Baton Rouge, LA

Job Summary:

Analyzes patient records daily to determine the appropriateness of admission, level of care, continued stay, and discharge. Abstracts variances to standard pathway process. Provides ongoing support and expertise through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Exercises concurrent review techniques utilizing evidence-based guidelines such as Interqual and Milliman to communicate with multidisciplinary personnel and insurance providers; Enhances the quality of patient management and satisfaction while promoting continuity of care and cost-effectiveness through the integration of utilization management, case management, and discharge planning. Performs various duties assigned by department management according to policies and procedures and the mission of Woman’s Hospital. This position pays shift differentials.

Job Knowledge:

Must have knowledge of computer software such as MS Office, McKesson Care Enhance Review Manager, and Milliman Care Guidelines Software, knowledge of ICD-9-CM and coding is preferred. Knowledge of Louisiana Bayou Health plans and Medicare/Medicaid guidelines is beneficial; certification in coding, Utilization Review/Mgmt, Case Mgmt or Quality Improvement Processes is also preferred.

Schedule:

Days (rotating bi-weekly each month):

Tuesday & Friday

Tuesday & Thursday

7:00/8:00am to 3:30/4:30pm

**Ability to pick up additional hours on occasional weekends (Saturday & Sunday 7:00a-3:30p)**

Salary :

$27.72 – $40.19