Our Job Post Completeness indicates how much vital information has been provided for this job listing. Academic Jobs has done the heavy lifting for you and summarized all the important aspects of this job to save you time.
Know Someone Great?
Help build our team with the best people you know.
Enter 1 or many referrals below.
Higher Ed Employee Referrals is only available for full job postings.
Position Summary: Rutgers University Correctional Health Care ( UCHC ) is seeking a Utilization Management Coordinator located in the central administration offices located in Trenton, NJ. The Utilization Management Coordinator performs utilization reviews for medical services provided by hospitals and other auxiliary medical services. Negotiates re-pricing charges for hospital and other auxiliary medical services. Duties include: Performs utilization/quality improvement reviews in accordance…
with established quality management procedures. Performs clinical/medical reviews for all changes in levels of care based on medical necessity criteria, continued length of stay reviews, and discharge follow up for all levels of care. Identifies pertinent clinical information necessary to certify admission and continued lengths of stay and or coordinate transfer back to NJDOC infirmary services and to evaluate quality of care in accordance with pre-established criteria. Consults with Statewide Medical Director/designee on all complex cases or continued stay issues. Assesses each patient being reviewed for high-risk status (multiple medical problems/multiple hospital admissions) and arranges as necessary clinical follow up on all identified high-risk patients. Performs data entry of assigned cases in a timely manner. Maintains close interaction with internal and external customers in a professional manner. Communicates in a professional and courteous manner. Works closely with medical personnel, billing, patient accounting, and utilization management departments of hospitals and other healthcare entities to maximize health care delivery within the prison system and minimize expenses for ancillary medical care and hospitalization while meeting the medically necessary medical treatment of the inmates. Develops and manages the existing UCHC provider network. Develops and maintains relationships with healthcare providers required to supplement the health care network available directly through UCHC within NJDOC facilities to assure inmates have access to medically necessary medical treatment. Minimizes the delivery of any healthcare by another healthcare entity that could be provided within the existing health care system within NJDOC . Obtains clinical information to substantiate medical necessity by reviewing patient charts, attending department rounds and treatment planning, and by talking to physicians and other healthcare providers. City: Trenton State: NJ Special Conditions: Must be approved by the Department of Corrections ( DOC ) and adhere to all DOC requirements. Posting Number: 26ST1850
AcademicJobs.com is the premier platform to discover Rutgers jobs, connecting talented professionals with exceptional career opportunities at one of the United States’ leading public research universities. Rutgers University, with campuses in New Brunswick, Newark, and Camden, New Jersey, is renowned for its academic rigor and innovative research, making Rutgers Uni jobs highly sought after by academics and professionals globally. Rutgers University careers offer a dynamic and inclusive environment for individuals to excel. Rutgers University university careers span a diverse range of disciplines, reflecting the university’s key areas of academic specialization, including health sciences, engineering, social sciences, business, and the arts. Employment Rutgers University includes roles such as professors, research fellows, lecturers, and professional staff positions, catering to various expertise levels. For those pursuing Rutgers jobs New Jersey, the university’s vibrant campuses provide a collaborative workplace in diverse urban and suburban settings near major metropolitan areas. Rutgers Uni vacancies and job postings are showcased on AcademicJobs.com, where candidates can explore opportunities in teaching, cutting-edge research, and administrative roles. Jobs at Rutgers University cover fields like biomedical research, environmental sustainability, and public policy, aligning with the university’s commitment to addressing global challenges through discovery and impact. Each Rutgers University vacancy is an opportunity to contribute to transformative initiatives within a distinguished academic community. Rutgers University Employment Opportunities are extensive, with Rutgers University job Opportunities ranging from academic faculty to technical and operational roles. A Rutgers University Career offers the chance to join an institution that values diversity, innovation, and community engagement. Rutgers Uni openings are regularly updated on AcademicJobs.com, ensuring access to the latest Rutgers University vacancies. Jobs at Rutgers Uni are ideal for those passionate about advancing knowledge and societal progress. Rutgers University job postings include positions in education, computer science, and professional services such as IT and student support. Rutgers University Employment through AcademicJobs.com connects talented individuals with Rutgers Uni vacancies, providing a seamless pathway to join a world-class university driving global change.
