UR COORDINATOR

First Health Care of Puerto Rico
FULL_TIME guaynabo, puerto rico, Guaynabo Assemblers and Fabricators
Posted:
March 02, 2026
Location:
guaynabo, puerto rico, Guaynabo, Puerto Rico

Job Description

Job Description

Responsibilities

The Utilization Review Coordinator (URC) is responsible for initial clinical review. URC may approve requests for admissions, procedures, and services that meet clinical review criteria, but must refer requests that do not meet clinical review criteria to peer clinical review for certification or non-certification.

Responsibilities and essential duties:

  • Visits the hospital facilities or receives the documentation via fax and perform the initial review of the clinical information.
  • Discuss the cases with the psychiatrists, psychologists, or social worker as appropriate to discuss medical necessity criteria for authorizations.
  • Maintains the daily census of the assigned facilities.
  • Responsible for making sure that the peer-to-peer discussion takes place.
  • Issues the services authorizations after the review is completed.
  • Maintains ...
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    Job Overview

    Job Type: FULL_TIME
    Location: guaynabo, puerto rico, Puerto Rico
    Posted: March 02, 2026
    Deadline: April 11, 2026