Utilization Review Specialist
Gainwell Technologies
Gainwell Technologies is seeking a Prior Authorization Registered Nurse Consultant - Personal Care Services to review prior authorization requests and determine medical necessity for Medicaid programs. This fully remote role supports providers and stakeholders while aligning with state policy guidelines and clinical standards. The successful candidate will possess a Wisconsin RN license (or eligible for Wisconsin licensure), five years of nursing experience, and prior authorization or #J-18808-Ljbffr
Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Utilization Review Specialist in Madison, WI vacancy
- ...Overview Utilization Specialist On-site Madison, WI Full time Why Join Competitive compensation with industry leading annual performance-based... ...and the facility professional clinical staff. Conduct reviews, in accordance with certification requirements, of insurance...SuggestedFull timeWork at officeLocal area
Harbor Oaks
Madison, WI1 day ago $18 - $20 per hour
...National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Utilization Review Coordinator PRIMARY PURPOSE : To assign utilization review requests; to verify and enter data in appropriate system(s); and...SuggestedWork at officeLocal areaFlexible hoursSedgwick
Madison, WI3 days ago$29.62 - $45.31 per hour
...Responsibilities Be responsible for all core functions in the Prior Authorization (PA) Department Coordinate and execute the review and research functions required to support the PA Department Investigate, review, and prepare all requests for prior authorization...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote workShift workProvidence Health & Service
Oregon, WI4 days ago- ...Utilization SpecialistOn-site Madison, WIFull timeWhy JoinCompetitive compensation with industry leading annual performance-based bonus... ...organizations and the facility professional clinical staff.Conduct reviews in accordance with certification requirements of insurance...SuggestedWork at office
Acadia Healthcare
Madison, WI3 days ago - Specialist III - Quality Assurance, SystemsPosition Summary:Work Schedule: M-F 8am-5pm100%... ...biomanufacturing, and biopharmaceutical development, utilizing flexible single‑use systems to enable... ...excellence.The Role:Perform quality review and approval on deviations, laboratory...SuggestedFull timeLocal areaFlexible hours
- ...join our team as a Treasury Management Specialist ! The Treasury Management Specialist is... ...Analysis Maintenance and Support - Input, review, process and maintenance all account... ...analysis statements for products and services utilized. Technical Support - provide onsite...Work at officeRemote work
Lake Ridge Bank
Madison, WI16 hours ago - ...Position Purpose: The Asset Protection Specialist is primarily responsible for preventing... ...their assigned store/multiple stores. They utilize tools to minimize loss to the Company,... ...identifying incidents of theft and fraud, reviewing CCTV and exception reports, monitoring...Local area
Home Depot
Madison, WI1 day ago $15 - $17.5 per hour
...procedures. • Maintains photo equipment and utilizes store systems and technology to support... ...continuity during times when the Photo Specialist is not scheduled. • Follows company... ...role will remain open until filled. To review benefits, please click here jobs.walgreens...Hourly payWork experience placementSeasonal workFlexible hoursAfternoon shiftWalgreens
Middleton, WI1 day ago- ...Senior Scheduling Specialist The Senior Scheduling Specialist reports to the Regional Director... ...stakeholders to ensure optimal resource utilization and data integrity, and to support... ...of Clinical Systems Administration, to review clinic scheduling performance, enhancements...
$37.71k - $62.19k
...and Unit Charge RN, the Behavioral Health Specialist I (BHS I) is responsible for providing... ...Program policies and procedures. Attends peer review and staff meetings as assigned.... ...situations in a safe, effective manner, utilizing the least restrictive, safe patient care...Part timeImmediate startShift workNight shiftWeekend work- ...Specialist I - Materials Management Catalent's Madison, Wisconsin site is a state-of-the... ...biomanufacturing, and biopharmaceutical development, utilizing flexible single-use systems to enable... ...career path and annual performance review and feedback process Diverse,...Monday to FridayFlexible hoursShift work
- We’re seeking a motivated Project Specialist - Electric Distribution to join our growing Electric... ...projectsLead quality control (QC) reviews for pre- and post-construction design packagesPrepare... ...and coordination with municipalities, utilities, and third-party stakeholders as...Full timeWork at officeRemote workWork from home
- ...Intake Specialist New Grads and Students encouraged to apply! The Intake Specialist serves... ...in the admissions process (screening, review and scheduling). As well as insurance verification... ...all forms to patients/guardians. Utilize e-signature to complete admissions...Part timeFlexible hoursShift workWeekend workWeekday work
$45k - $65k
Intellectual Property (IP) Docketing Specialist Michael Best is seeking an Intellectual Property... ...support to the docket team. This role utilizes the firm’s IP business docketing... ...deadlines in a timely and accurate manner. Review data for accuracy and promptly resolve discrepancies...Temporary workWork at officeLocal areaFlexible hours$63 per hour
...as related civil structures (roads, dams, bridges, facilities, utilities, etc.) to verify compliance with approved design specifications... ...construction, required corrective actions and any needed sampling. • Review contractor submittals, RFIs, shop drawings, and material...Contract workFor contractorsWork experience placementH1bImmediate startOverseasFlexible hoursCDM Smith
Madison, WI3 days ago$116k - $161k
...and paid time off.Job SummaryLead Maintenance and Reliability Specialist is a critical role responsible for maximizing the reliability,... ...recommendations to develop or change equipment standards and may review the recommended changes and improvements of others.Identifies,...Full time- ...the right services at the right time? In this role, you will review clinical documentation to determine medical necessity and appropriateness... ...medical record system; apply evidence‑based criteria to utilization management reviews; document clinical determinations; provide...Full timeContract workRemote workWork from home
- DescriptionPosition at First Business BankJoin us today as the Private Wealth Specialist - Team Lead!First Business Bank is a Top Workplaces USA... ...to maintain operational effectiveness.Conduct quality reviews and identify opportunities to improve processes, reduce risk,...3 days per week
- ...Scientist specializing in respiratory for an upcoming opportunity. This role focuses on developing medical plans, conducting data reviews, and collaborating with medical directors and project teams to ensure quality and compliance. Ideal candidates should possess an advanced...Flexible hours
Syneos Health/ inVentiv Health Commercial LLC
Madison, WI2 days ago $88k
...The Senior Strength and Conditioning Specialist serves as the lead representative for all matters related to strength and conditioning... ...Ensure equipment and facilities are properly cleaned, organized, utilized, and maintained in safe working condition. Enhance and...Civilian ContractorFull timeContract workTemporary workLocal areaHome officeMAXIMUS
Madison, WI3 days ago- ...substance biomanufacturing, and biopharmaceutical development, utilizing flexible single‑use systems to enable rapid scale‑up and customization... ...SOP training as needed.Participate in team meetings and track/review training records for accuracy.Communicate decisions, policies,...Full timeWork at officeLocal areaMonday to FridayFlexible hoursShift work
- Specialist II - Quality Assurance Operations, CompliancePosition Summary:Work Schedule: M-F 8am-5pm100% on-siteWorking for Catalent Biologics... ...wide systems training, internal and external auditing, project review actions to ensure regulatory compliance, which is essential in...Full timeLocal area
- ...26Wage Level:SalaryJOB DESCRIPTION:Position Title: Facilities Specialist Location: Madison, WIDepartment: Quality ControlReporting To:... ...equipment onboarding, work plan template creating/editing, work order reviews, and asset decommissioning.Lead or support special projects...Full timeContract work
- POSITION: Lease-Up Specialist (Full-Time, Non-Exempt)COMPENSATION: Biweekly, plus Benefits and Bonus eligibilitySUMMARYA Lease-Up Specialist... ...and beyond to ensure that Cardinal customers are satisfied. Utilize the Cardinal Way of Leasing by:a. Warmly greeting prospective...Full timeWork at officeLocal areaRemote work
- ...Scientist specializing in respiratory for an upcoming opportunity. This role focuses on developing medical plans, conducting data reviews, and collaborating with medical directors and project teams to ensure quality and compliance. Ideal candidates should possess an advanced...Flexible hours
- CBRN Specialist Job Overview: If you're passionate about cutting-edge technology and playing a key role in occupational safety, this is... ...the opportunity you've been waiting for. Your role will involve utilizing state-of-the-art equipment and technologies to safeguard the...Full timeContract workPart timeImmediate startRelocation packageFlexible hours
US Army
Madison, WI23 hours ago - ...CT Tech / Imaging Specialist / ARRT Explore Your Potential as a CT Tech in the Enchanting Capital of Wisconsin Madison, Wisconsin... ...of those you encounter. Responsibilities Awaiting You Utilize your expertise to conduct radiographic and CT procedures,...Local areaFlexible hours
MLee Healthcare Staffing and Recruiting, Inc
Madison, WI16 hours ago - ...fittings with attention to detail. As a remote contractor, you can accept local client requests through the platform and build a reputation with repeat clients and reviews, while maintaining a flexible schedule that fits your availability. #J-18808-Ljbffr Thimble AlterationsRemote jobFor contractorsLocal areaFlexible hours
- ...warranty, price, discount, warehousing, and delivery. Drive the best global supply of commodities; including identifying opportunities, utilizing cross-functional resources to implement projects through six sigma rigor, and speed in execution. Use e-commerce tools to execute...
Springs Window Fashions
Middleton, WI5 days ago $77k - $85k
...Job Title: Construction Safety Specialist Job Description The Construction Safety Specialist promotes a strong safety culture on construction... .... Attend daily end-of-shift meetings when possible to review safety performance, discuss concerns, and identify opportunities...Permanent employmentShift workDay shiftActalent
Madison, WI3 days ago
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Review Specialist. Be the first to apply!
Related searches
- candidate experience specialist Madison, WI
- gaming specialist Madison, WI
- information technology specialist Madison, WI
- leasing specialist Madison, WI
- infectious disease specialist Madison, WI
- measurement specialist Madison, WI
- wildlife specialist Madison, WI
- prevention specialist Madison, WI
- inclusion specialist Madison, WI
- reading specialist Madison, WI