This position will work closely with the Prime Healthcare Provider Network and with each of the hospital's Medical Directors. Prime Healthcare is actively seeking new members to join our corporate team Responsibilities: The Utilization Review Coordinator is responsible for the assisting with the implementation and ongoing management of the utilization review program for the employee medical benefit program for Prime Healthcare.

Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.

The Utilization review tech will further support the department needs for Release of Information through faxing and mailing, discharge coordination or other duties as assigned. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers.

Prime Healthcare Management Inc. offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs.

IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan. We are also one of the largest employers in the region, designated as “Great Place to Work.” With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members.

Responsible for representing the Inland Empire Health Plan in a friendly and professional manner while answering the calls for the Utilization Management Department. Communicate with providers/facilities in consultation with the Utilization Management Nurse, regarding authorizations, orders, and clinical reviews.

Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, & obtaining all authorizations/approvals as needed for outside services for patients/families.

Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management. Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient & non-KFH facilities.

Responsible for ensuring that Members receive Home Health or Durable Medical Equipment (DME) items as ordered via phone call and documentation of call within the medical management system.

Adheres to internal and external regulatory and accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA and DOL.- Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources.

Under the direction of the Chief Appraiser, the Appraisal Review Officer is responsible for conducting residential and commercial appraisal reviews and assists with appraisal review engagement process as directed by the Chief Appraiser.

General Purpose of the Job:Under the direction of the Chief Appraiser, the Appraisal Review Officer is responsible for conducting residential and commercial appraisal reviews and assists with appraisal review engagement process as directed by the Chief Appraiser.

Communicates, collaborates, and participates with Therapy Provider Network team during meetings, and events intended to improve the level of efficient and effective quality service being delivered and to achieve other Therapy Services initiatives.

Other administrative duties as needed, including answering phones and processing purchase orders. - Responsibilities include a wide range of administrative duties, such as completing customer contracts, ordering equipment for job sites, collaborating with subcontractors to meet requirements, keeping to customer schedules, meeting project deadlines, processing customer invoicing, tracking payments, and successfully managing multiple projects at a given time.

Bid processing (processing samples, assemble documents, collect bid recaps) + Has the ability to evaluate subcontractor costs and review same for completeness. Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America.