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
- ...Utilization Review Specialist Mindful Health is a healthcare provider in Texas that offers a high‑end client experience through both in‑person and virtual services. Job Summary Utilization Review Specialist: responsible for ensuring adherence to Mindful Health’s utilization...SuggestedTemporary workWork at officeLocal areaMonday to Friday
$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 work- ...Director of Utilization Review Under the direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations... ...for clients receiving behavioral healthcare services from Odyssey House's Part 820 residential...SuggestedTemporary workFlexible hours
- ...Mindful Health is seeking a Utilization Review Specialist in Texas to ensure adherence to utilization review plans by evaluating the effectiveness and medical necessity of outpatient services. The ideal candidate will have strong communication skills, efficient time management...SuggestedWork at office
- ...Position responsibilities will include utilization management support functions for patient... ...of need for initial and continued stay reviews, and process continued stay and... ...innovation as we work together to transform healthcare. We encourage all team members to actively...SuggestedFull timeTraineeshipWork at officeLocal areaShift work
- A healthcare staffing agency in New York is seeking a Clinical Utilization Specialist to oversee the authorization of services for geriatric populations. The ideal candidate... ...utilization. Responsibilities include reviewing health services for medical necessity and collaborating...
- ...A leading healthcare services provider is seeking a 100% Remote Hematology Oncology MD/DO Reviewer. Responsibilities include conducting thorough medical reviews to determine treatment coverage eligibility based on medical necessity and investigational status. Candidates...Remote work
- ...A healthcare consulting firm is seeking an experienced Orthopedic Surgeon to conduct comprehensive reviews of clinical cases as an independent contractor. This telework opportunity allows for schedule flexibility, where you will review medical records, prepare clinical...For contractorsRemote work
- ...Responsibilities include supporting physician education, participating in Utilization Review, and managing complicated cases to improve efficiency and... ..., analytical skills, and a solid understanding of healthcare regulations are essential for success in this position. #J-1...Remote job
- ...Computer Solutions is seeking a candidate for a role focused on utilization management based in Georgia, USA. This position involves... ...optimizing management processes, and ensuring compliance with healthcare regulations. Candidates must have 3-5+ years of experience in...
- A prominent healthcare institution in New York is seeking a Utilization Management Specialist to coordinate clinical information requests and provide support for patient admissions. The role requires an Associate's degree and at least 2 years of relevant experience. Key...
$60.2k - $107.4k
Stryker Corporation is hiring a Utilization Management RN Coder who will review medical records and craft appeal letters. This remote role requires a working knowledge of coding systems like ICD-9, ICD-10, and CPT. The ideal candidate should possess an Associate's degree...Remote job$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$95k - $131k
...published more than 20 peer-reviewed studies, and delivered unmatched... ...annual reduction in overall healthcare claims costs. Lyra is... ...Google Workspace expertise, this specialist will drive various DLP and... ...secure data sharing policies. Utilize GWS Audit Logs for security...Full timeRemote work$10k
...dramatically expanding access to healthcare by reimagining the patient... .... As a Patient Engagement Specialist I, you are often the first... ...Specialist I Your day will begin by reviewing and following up on inbound... ...Throughout the day you will utilize deep prospecting techniques...Flexible hours- ...Position: Case Review Specialist – Phone Intake & Documentation Location: Remote Remote Status... ...bachelor’s degree preferred, especially in Healthcare Administration, Health Information... ...experience in healthcare operations, utilization management, case management, intake, call...Work at officeLocal areaRemote workMonday to FridayShift work
$47k - $50k
...housing. Position: Housing Specialist Reports To: Sup II (Clinical... ...such matters as education, healthcare, housing, social services,... ...etc.) and local landlords. Review all approved housing... ...and all payments to landlord/utilities are up-to-date with apartment...Permanent employmentFull timeTemporary workLocal area- ...Life Safety Code Specialist (LSCS) Location: Remotely – Home Office... ...leads the transformation of healthcare facilities management by incorporating... ..., DNV, and others. The LSCS reviews each facility’s Life Safety... .... Document all observations utilizing applicable Medxcel FM...Local areaRemote workHome officeFlexible hoursNight shift
$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... ...applications. Duties/Responsibilities Review patient files for completeness and accuracy...Full timeContract workTemporary workLocal areaRemote workFlexible hours- ...3 USA is at the forefront of healthcare innovation, offering digital... ...growth, fueled by our mission to utilize the internet for a healthier... ...seeking a Campaign Delivery Specialist at MDLinx. This is a remote... ...program kick‑off and concept review meetings; take notes and circulate...Local areaRemote workFlexible hoursShift work
- ...need for a talented Appeals Specialist II . This is a 06+months contract... ...in U.S(Remote). Please review the job description below and... ...learning system/processes Utilization Management Billing/coding (typically... ...GED Our client is a leading Healthcare Industry, and we are...Contract workLocal areaImmediate startRemote work
$23.1 per hour
...We are currently seeking a Health Care Specialist (HCS) to work full-time at our Bay Ridge... ...direct care staff . Conducts timely reviews of anecdotals and presents questions to... ...Basic computer skills – including email, utilizing Workday and related systems (DA, etc.) to...Full time- ...Senior Specialist, Talent Acquisition at nTech Workforce Location: 100% Remote,... ...DC, or VA. Overview: Join a leading healthcare organization as a Utilization Management Coordinator on the Commercial... ...and create medical authorizations. Review patient cases for missing discharge...Work at officeRemote work
$47k - $50k
...organizations regarding such matters as education, healthcare, housing, social services, legal issues,... ...unit, etc.) and local landlords. Review all approved housing packages to... ...(DOB, HPD) and all payments to landlord/utilities are up-to-date with apartment in move-in...Permanent employmentFull timeTemporary workLocal areaImmediate start$24.72 - $30.21 per hour
Overview Disengagement and Discharge Specialist Join a Healthcare Force for Good! $24.72-$30.21 per hour... ...months of service provision. The DDS reviews the client’s discharge plan, closes... ...the client at the time of discharge. Utilizes the Electronic Health/Medical Record,...Hourly payWork at office$154.2k - $328.4k
...talented individual to join our Casualty Healthcare team at Marsh specializing. This role... ...such as ensuring procedural compliance, reviewing data and updating annual renewal... ...coverage Formulates Placement strategy by utilizing substantial risk expertise and knowledge...Minimum wageFull timeContract workWork at officeLocal areaImmediate startRemote workFlexible hours3 days per week1 day per week- Position Title: Coding Integrity Specialist - Education/Auditing... ...necessity. General Description Reviews and evaluates hospital... ...the appropriate ICD-10-CM and Healthcare Common Procedure Coding System... ...and skills remain current Utilizes the complete medical record...Work at office
- ...The Behavioral Health Admissions Call Specialist coordinates admission functions, provides... ...respected providers of hospital and healthcare services, Universal Health Services,... ...insurance coverage via Business Office and Utilization Review. Completes the admissions process by...ReliefWork at officeLocal areaAll shiftsMonday to FridayFlexible hoursDay shift
$24.04 - $26.44 per hour
...Medical imaging is a fundamental piece of healthcare; from prevention to diagnosis and... ...productivity and effectiveness and is constantly reviewing customer workflows, queries, and... ...and exceed structured performance targets Utilize internal materials as a foundation for resolving...Hourly pay$108.6k - $250.7k
...through strong partnerships across the healthcare system. In a complex and rapidly evolving... ...actionable plans that increase appropriate utilization, support continuity of care, and deliver... ...disclosure. Subject to further legal review and statutory or regulatory clarification...Permanent employmentContract workWork experience placementH1bWork at officeLocal areaVisa sponsorshipWork visaRelocation packageNight shift
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare Utilization Review Specialist. Be the first to apply!
- bank reconciliation specialist New York, NY
- remote outreach specialist New York, NY
- deployment specialist New York, NY
- member experience specialist New York, NY
- strategic sourcing specialist New York, NY
- demo specialist New York, NY
- cash reconciliation specialist New York, NY
- invoice specialist New York, NY
- privacy specialist New York, NY
- member engagement specialist New York, NY

