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
$80 per hour
...are sharing a specialised part-time consulting opportunity for United States-based healthcare professionals experienced in prior authorization, utilization management, clinical review, medical necessity criteria, payer authorization workflows, documentation review, and...SuggestedHourly payPart timeFor contractorsWork at officeRemote workFlexible hours- 100 LCMC Health is seeking an RN for Utilization Review to support patient throughput and physician communication while ensuring payer requirements are met. Responsibilities include care reviews, medical necessity determinations, and accurate status assignments per CMS...SuggestedShift workWeekend work
- Phoebe Putney Memorial Hospital in Albany, GA, is seeking an RN UR Specialist to manage utilization review activities, secure authorizations, and support medical necessity justification for hospital services. You will liaise with insurance payers and care management staff...SuggestedFull time
- ...related Streaming Services. Standards & Practices Associates review high profile national advertising campaigns to ensure... ...communication, claim support, and other documentation obtained and utilized in the clearance process is an integral part of this role. The...SuggestedContract workFixed term contractWork at officeRemote work
- CVS Health is seeking a Utilization Management Nurse Consultant to coordinate, document and communicate all aspects of the utilization/benefit... ..., while adhering to federal and state turnaround times and reviewing clinical records. This full-time, remote role requires Monday-...SuggestedRemote jobFull timeMonday to Friday
$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- NeueHealth is seeking a Utilization Management Prior Authorization Nurse to ensure appropriate benefit coverage and evidence-based care... ...You will collaborate with Medical Directors and clinicians to review authorizations for treatments, medications, and tests, while tracking...
- ...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... ...exempted from these requirements will be reviewed by Datavant Human Resources and...Full timeWork experience placementWork at officeMonday to Friday
- ...themselves to making a difference in the healthcare industry, and in people's lives. Work... ...Registration, Emergency Registration, Utilization Review, Nursing, Social Services, and Patient... ...to meet with the Talent Acquisition Specialist to assess other positions available within...Work at officeShift work
- ...provides the highest quality healthcare services to residents of... ...000 primary care providers, specialists and participating clinics. For... ...CMA worker is unavailable. Utilize personal lived experience with... ...Treatment/Recovery Plans will be reviewed and signed by Team Leader...Work at officeLocal areaTrial period
- ...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
$57.7k
...care, helps members to coordinate their healthcare services and navigate the healthcare system... ...telephonic contact with each member to review progress and assess the potential for... ...Management Certification Skills Proficiency in utilizing PC‑based system application and...Remote jobTemporary workFor contractorsWork at officeLocal area$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$56.27k - $69.9k
...What We’re Looking For Trillium Health Resources has a career opening for a Utilization Management Specialist II to join our team! The Utilization Management Specialist II supports clinical review by validating service authorization requests and managing workflow from...Work at officeImmediate startRemote workWork from homeFlexible hours- ...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
- Trillium Health Resources is seeking a dedicated Utilization Management Specialist II to support clinical review by validating service authorization requests and coordinating workflow from intake to determination. You will verify documentation, route cases to clinical staff...Remote job
- ...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
$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- ...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...Remote jobLocal areaFlexible hoursShift work
- Senior Specialist, Talent Acquisition at nTech Workforce Location: 100% Remote, but... ..., or VA. Overview: Join a leading healthcare organization as a Utilization Management Coordinator on the... ...and create medical authorizations. Review patient cases for missing discharge...Work at officeRemote 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
$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$120k - $125k
...here. Medtronic is a global leader in healthcare technology with a Mission to alleviate... ...outcomes. Join Medtronic as an EP 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- UnitedHealth Group is seeking a licensed psychologist to perform peer reviews for Commercial, Medicaid and Medicare cases, applying clinical criteria to determine coverage decisions and shaping treatment as needed. The role supports outpatient and Medicaid services with...Remote job
$72.5k - $154.3k
Marsh is seeking candidates to join our Healthcare Placement team focused on medical professional liability based in our New York or Chicago... ...production such as active participation in RFPs and coverage reviews Coverage expertise to be able neg and drive optimal terms on...Minimum wageWork at officeLocal areaRemote workFlexible hours3 days per week1 day per week- Optum, part of UnitedHealth Group, seeks a licensed psychologist to perform peer reviews across Commercial, Medicaid, and Medicare cases, applying clinical criteria and benefit plan requirements to continue coverage or issue adverse determinations. New York, New Jersey,...Remote job
- UnitedHealth Group is seeking a licensed psychologist to perform peer reviews across Commercial, Medicaid, and Medicare cases, applying clinical criteria and benefit plan requirements to determine coverage decisions. The role emphasizes collaboration, adherence to guidelines...Remote work
$96.3k - $178.8k
The PositionSurgical Device Specialist (SDS), Ophthalmology - NY MetroAn ever-transforming healthcare landscape requires a high level of agility and flexibility to navigate... ...relationships, conduct quarterly business reviews, and leverage marketing materials for consultative...Full timeLive inLocal areaRelocation packageNight shiftWeekend workAfternoon shift- ...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
$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
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