Healthcare Utilization Review Specialist
$20 - $30 per hourGuidelight Health
A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include conducting live reviews, coordinating with clinical teams, and ensuring compliance with regulations. The position offers a pay range of $20 - $30 USD, along with comprehensive benefits including medical, dental, and professional development opportunities. #J-18808-Ljbffr
$20 - $30 per hour
A behavioral healthcare organization is seeking a Utilization Review Specialist to conduct clinical auditing and negotiate authorizations. The ideal candidate has a Bachelor's degree in Social Work or Nursing and 1-2 years of healthcare experience. Responsibilities include...Suggested$50k
Employer Industry: Behavioral Healthcare Management Why consider this job opportunity Starting pay up to $50,000 per year... ...Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary...SuggestedRemote job- ...Solutions-LLC is seeking an experienced Registered Nurse (RN) - Utilization Review to assess medical necessity, appropriateness, and level of... ...with physicians, case managers, health plans, and other healthcare professionals to ensure appropriate utilization of services....Suggested
- A healthcare facility in California is seeking experienced nursing professionals to review medical records and ensure appropriate admission status. The role involves collaboration with various stakeholders, including physicians and Care Coordination staff, to support patient...SuggestedRemote work
- ...support the Ethos Medical Management Team, the full-time Utilization Review Specialist will ensure the efficient and timely processing of Utilization... ...diploma or equivalent required Minimum of 1 year in a healthcare-related setting Knowledge of HIPAA rules and regulations...SuggestedFull timeWork at officeRemote work
- A leading medical review organization is seeking Board-Certified physicians in Gastroenterology for a flexible remote opportunity. This role requires conducting independent Utilization Reviews for just 1-2 hours per week, with no minimum commitment. Candidates must have...Remote workFlexible hours
- Mass Digital Health is seeking a Clinical Reviewer LPN for a work-from-home position. The role involves performing retrospective medical reviews based on patient eligibility and contract requirements, requiring clinical expertise and knowledge of Medicaid guidelines. Candidates...Remote jobContract workWork from home
$32.85 - $35.71 per hour
Broadcast Standards & Practices Associate / Ad Review Specialist 2 days ago Be among the first 25 applicants Get AI-powered advice on this... ..., claim support, and other documentation obtained and utilized in the clearance process is an integral part of this role....Fixed term contract$76k - $199.6k
...maintain customer engagement by successfully utilizing existing and ever-changing digital tools... ...and/or Account Management Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist,... ...disclosure. Subject to further legal review and statutory or regulatory clarification...Permanent employmentFull timeH1bLocal areaRemote workVisa sponsorshipWork visaRelocation package$76k - $199.6k
..., including Therapeutic Area Specialists, and Key Opinion Leaders (KOLs... ...and in-person settings; utilize a systematic approach to virtual... ...Account Management Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist... .... Subject to further legal review and statutory or regulatory...Permanent employmentFull timeH1bLive inLocal areaRemote workVisa sponsorshipWork visaRelocation package$40 - $50 per hour
...Summers , and Jack Dorsey . Position: Healthcare Administrative Specialist Type: Contract Compensation... ...processes for prior authorizations and utilization support using real-world tools. Review and manage claims and revenue cycle...Full timeContract workSummer workWork at officeRemote work- ...PAHub & Prior Authorization Specialist serves as a trusted consultant... ...calls, workshops, business reviews, and operational meetings.... ...Optimization Assess customer utilization of PAHub and identify opportunities... ...5+ years of experience in healthcare operations, prior...Local areaRemote work
- ...data collaboration platform trusted for healthcare. Guided by our mission to make the world... ...Basic computer proficiency. Comfortable utilizing phones, fax machine, printers, and other... ...from these requirements will be reviewed by Datavant Human Resources and determined...Full timeWork experience placementWork at office
- ...continually strive to be the healthcare leader in quality,... ...experience? JOB SUMMARY: The Coding Specialist operates as a member of the... ...DUTIES AND RESPONSIBILITIES: Reviews medical records to assign accurate... ...level of service selection. Utilizes coding software, encoder and...Temporary workMonday to Friday
$80k - $120k
Program Controls Specialist - Utility Field Safety Operations Location : Somerset, NJ Job Type : Full-time Schedule : Monday through Friday... ..., training, badging, and access-readiness status Review labor-hour trends, staffing utilization, overtime, inactive...Full timeFor contractorsLocal areaMonday to FridayShift work$18.92 - $23.46 per hour
Recognized as a "Best Place to Work Modern Healthcare" - Join a team where people come first.... ...matters. Proven knowledge and skill in utilizing MS Office suite of software and pharmacy... ...Meridian, MS. Duties/Responsibilities: Review patient files for completeness and...Full timeContract workTemporary workLocal areaImmediate startFlexible hours- Provider Enrollment Specialist - Remote US It takes great medical minds... ...solutions that solve some of healthcare's most complex challenges.... ...stakeholders. Your role in our mission: Review and process initial provider... ...and operational standards. Utilize claims systems, reporting...Remote jobWork at officeMonday to FridayFlexible hoursShift work
$22 - $25 per hour
...equitable, community-driven healthcare. Our Values Lead with integrity... ...of individuals through the utilization of evidence based approaches... ...and Community Engagement Specialist with delegated tasks... ...participating in systematic case reviews and consulting with nurse care...Remote jobFull timeWork experience placementLocal areaWork from homeFlexible hours- ...Radiologic Technologist / Imaging Specialist / CT Discover the vibrant... ...to be at the nexus of healthcare and compassion. Each day, you... ...quality images for physician review. Engage collaboratively with... ...contributions are valued, your skills utilized, and each day presents a...Flexible hoursDay shift
- A healthcare service provider is seeking an Appeals and Grievances Clinical Specialist to manage member complaints and clinical case resolutions. This is a 100% remote... ...experience in clinical practice and knowledge of Utilization Review Guidelines. The position offers a...Remote work
- ...About Amperos Amperos is healthcare's first AI-native denial management and revenue recovery... ...for a Senior Accounts Receivable Specialist to join our client onboarding team — a small... ...detail to act on immediately Conduct QA reviews of permanent BA work during the...Permanent employmentFull timeWork at officeImmediate startFlexible hours
- ...CT Imaging Specialist / Radiologic Technologist Scan with Intention... ...those who contribute to its healthcare ecosystem. If you are a dedicated... ...Key Responsibilities Utilize radiographic and CT... ...diagnostic images for physician review Collaborate seamlessly with...Flexible hoursWeekend work
$42 per hour
...Medicare Annual Wellness Visit Specialist - PRN Full-time WHO IS... ...powered, performance-driven healthcare company dedicated to operational... ...are completed. Virtually reviewing and updating patient medical... ...factors for chronic diseases, utilizing remote monitoring tools when...Bi-weekly payFull timeTemporary workFor contractorsReliefLocal areaRemote workWork from homeMonday to Friday- ...GroupAt CMI Media Group, we are delivering healthcare marketing at the speed of life. Our... ...looking for a proactive, detail-oriented Specialist, Audit & Compliance to join our team. In... ...and track PBC (Provided by Client) lists, review submissions for completeness, and manage...Flexible hours1 day per week
- ...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...DescriptionJoin Medtronic as an Affera Mapping Specialist and be at the forefront of transforming... ...addition, your driving record will be reviewed and will be considered as part of your...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift
$60 per hour
...in the field. The Per Diem Diagnostic Specialist (Ultrasound/Micro-Ultrasound) performs... ...equipment and organization of x-ray films. Utilizes PACS system to process films,... ...innovation as we work together to transform healthcare. We encourage all team members to actively...Hourly payDaily paidTraineeshipLocal area- WHO WE ARE:Community Healthcare Network (CHN) is a not-for-profit organization providing more than 65,000 New Yorkers with primary and... ...including attending meetings as appropriate, and collecting, reviewing and producing educational materials.6. Refers clients to other...
$90.58k - $114.59k
...ofTitle: Mental Hygiene Program Evaluation Specialist 3 (NY HELPS), Kingsboro Psychiatric... ...Coordinating and monitoring survey and related review activities. Minimum Qualifications :... ...includes: design, modification, and/or utilization of data collection instruments and process...Permanent employmentFull timeWork at officeRemote work$135k - $140k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...addition, your driving record will be reviewed and will be considered as part of your... ...infectious disease and radiation Clinical Specialists are required to be within their assigned...Full timeWork experience placementH1bWork at officeLocal areaImmediate startRemote workWorldwideFlexible hoursNight shift$50k
...bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment... ...including DRG Validation, Cost Outlier and Readmission reviews. The Appeals Specialist I is responsible for performing triage, review, analysis...Contract workWork experience placementRemote work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare Utilization Review Specialist. Be the first to apply!
- fmla specialist New York, NY
- wire specialist New York, NY
- emr specialist New York, NY
- letter of credit specialist New York, NY
- candidate experience specialist New York, NY
- gaming specialist New York, NY
- channel specialist New York, NY
- information technology specialist New York, NY
- leasing specialist New York, NY
- threading specialist New York, NY


