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 Guidelight Health
- ...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
$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- Capital Health is seeking a Clinical Denials Utilization Review RN in New Jersey to manage utilization reviews related to inpatient care. The role involves overseeing denial and appeal processes, ensuring compliance with CMS guidelines, and requires a minimum of five years...Suggested
- ...Hospital, Inc. in Georgia is seeking a Registered Nurse UR Specialist. Key responsibilities include managing insurance notifications... ...have a minimum of 4-5 years in acute care and 1-2 years in utilization review. This position requires a Georgia RN license and a commitment...Suggested
$23.01 - $34.24 per hour
...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...SuggestedHourly payFull 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 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...Remote jobFor contractors
- Overview What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients...Work at officeLocal area
- BriteLife Recovery in Englewood, New Jersey, is seeking a Utilization Review Specialist to oversee insurance authorization for clients receiving substance use disorder treatment. This critical role involves collaborating with clinical staff and third-party payers to ensure...
- ...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...
$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$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$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$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$17 - $19.69 per hour
...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...Hourly payWork experience placementWork at officeMonday to Friday$53k - $70k
...that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported... ...to meet you. About the Role Our Specialist, Onboarding Compliance will be directly... ...care in multiple states and are reviewed regularly by state agencies. The Specialist...Full timeFor contractorsWork at officeLocal areaRemote work$70k - $180k
...maintain customer engagement by successfully utilizing existing and ever-changing digital tools... ...and/or Account Management Relevant Healthcare/Scientific roles (e.g., RN, Pharmacist,... ...public disclosure. Subject to further legal review and statutory or regulatory...Remote jobPermanent employmentFull timeWork at officeLocal areaRelocation packageNight shift$23.01 - $34.24 per hour
A prominent healthcare institution in New York is seeking a candidate to coordinate clinical information requests and manage payer authorizations. Responsibilities include communication with third-party payers, data entry, and reporting, as well as supporting case managers...Hourly pay- 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
$16.5 - $19.69 per hour
Health Information Specialist I Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world... ...proficiency. Comfortable utilizing phones, fax machine,... ...these requirements will be reviewed by Datavant Human Resources...Hourly payWork experience placementWork at officeMonday to Friday$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$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- Position: Case Review Specialist - Phone Intake & Documentation Location: Remote Remote Status... ...’s degree preferred, especially in Healthcare Administration, Health Information Management... ...experience in healthcare operations, utilization management, case management, intake,...Work at officeLocal areaRemote workMonday to FridayShift work
- 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
$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$18.65 - $19.9 per hour
...hospitals healthy. We recognize that healthcare requires a human touch, and... ...Financial Counseling Specialist performs the task of benefit... .... This includes face to face review of inpatient benefits, authorization... ...Inpatient Collections will utilize face to face communication...Local areaRemote workNight shiftWeekend work$18.92 - $23.46 per hour
Recognized as a “Best Place to Work Modern Healthcare” - Join a team where people come first.... ...applications. Duties/Responsibilities Review patient files for completeness and... ...documentation. Proven knowledge and skill in utilizing the MS Office suite of software and...Full timeContract workTemporary workLocal areaRemote workFlexible hours- ...provides the highest quality healthcare services to residents of... ...000 primary care providers, specialists and participating clinics. For... ...CMA worker is unavailable. Utilize the personal lived experience... ...Treatment/Recovery Plans will be reviewed and signed by Team Leader...Work at officeLocal areaTrial period
$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- ...Associate Vice President, Space Planning & Utilization About the Company Acclaimed clinical research & medical care center Industry... ...Databases Specialties medicine education healthcare science and biomedical research Business Classifications...
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