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
$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- ...is a nationally recognized behavioral healthcare institution that delivers quality, medically... ...For We are seeking an experienced specialist who is passionate about making a... ...field required preferred. 2-3 years of utilization review experience in behavioral health, addiction...SuggestedDaily paidFull timeRemote work
- ...WNS, part of Capgemini, seeks a remote Utilization Review Nurse to perform medical necessity reviews and collaborate with providers to ensure... ...two years in utilization review or related fields, and proficiency with Microsoft Office and healthcare software. #J-18808-LjbffrSuggestedWork at officeRemote work
- ...The Arizona Health Care Cost Containment System (AHCCCS) is seeking a Behavioral Health Prior Authorization Utilization Review Consultant. The role focuses on monitoring, evaluating, and approving or denying payment for medical and behavioral health services for the Fee...SuggestedRemote work
- ...FHE Health in the United States seeks an experienced Utilization Review Specialist to manage clinical authorization processes, ensuring timely, accurate, and compliant communications with insurance payers. You will support patient access by securing initial and continued...SuggestedRemote work
$69.39k - $88.61k
...Cincinnati Children’s is seeking an experienced Utilization Review professional for a remote role in the United States. The position supports case management, authorization, compliance, and education within the Utilization Review department. The role requires a Bachelor...Full timeRemote work- ...Odyssey House is looking for a Full-Time Utilization Review Specialist. Summary: Odyssey House's Mission is "Empowering people to heal and build... ...received Top Workplace Awards. Join our amazing team of healthcare professionals today!" Full-Time Benefits: $9k per year tuition...Full timeContract workTemporary workCasual workLocal areaImmediate startFlexible hoursShift work
- Spectrum Billing Solutions is seeking an ABA Utilization Review Specialist to review clinical data and obtain authorized services for ABA and related treatments. This role offers either remote work or a home-office hybrid setup, with collaboration across clinical staff...Remote jobWork from homeHome office
- The Utilization Review Specialist's primary role is the liaison between the hospitals inpatient and ambulatory services and the managed care organizations... ..., Benefits and Patient Accounts. One year experience in Healthcare and/or Managed Care Setting required. Undergraduate/...
- Odyssey House is seeking a Full-Time Utilization Review Specialist to support medical necessity reviews, documentation, and coordination with billing and staff. The role emphasizes thorough UR processes, training, and timely submissions. The ideal candidate will hold a...Full timeFlexible hours
$37.5 - $54.25 per hour
...Your Clinical Expertise to Logan Health’s Utilization Management Team! Our Mission: Quality,... ...searching for a Utilization Management Specialist to join our dedicated team! Our... ...Management Specialists play a vital role in reviewing admissions across the Logan Health system...Full timeImmediate startRemote work10 hours per weekShift workRotating shiftWeekend workDay shiftAfternoon shift$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- ...advanced care to our neighbors throughout the region. Organization Utilization Management Job Summary Facilitates optimal reimbursement... ...is ordered. Conducts initial admission based on utilization review medical necessity criteria. Refers cases for secondary review...Remote jobTemporary workWork experience placementLive outFlexible hours
- ...provides the highest quality healthcare services to residents of... ...000 primary care providers, specialists and participating clinics. For... ...worker is unavailable. Utilize the personal lived experience... ...Treatment/Recovery Plans will be reviewed and signed by Team Leader...Work at officeLocal areaTrial period
$17 - $20 per hour
...collaboration platform trusted for healthcare. Guided by our mission to... ...(ROI) Health Information Specialist to support two medical... ...computer proficiency. Comfortable utilizing phones, fax machines,... ...these requirements will be reviewed by Datavant Human Resources...Hourly payFull timeWork experience placementWork at officeLocal areaMonday to Friday$17 - $20 per hour
...collaboration platform trusted for healthcare. Guided by our mission to... ...(ROI) Health Information Specialist to support two medical... ...computer proficiency. Comfortable utilizing phones, fax machines,... ...these requirements will be reviewed by Datavant Human Resources...Hourly payFull timeWork experience placementWork at officeLocal areaMonday to Friday- ...their clients, and the whole healthcare community. Job Description At... ...to their clients. As an RCM Specialist II, you will serve as a trusted... .... What You’ll Do Submit, review, correct, and process denied,... ...efficiency and customer outcomes. Utilize technology and available...Work at office
- Welcome to Ovation Healthcare! At Ovation Healthcare (formerly QHR... ...highly skilled subject matter specialists and operations executives in... ...for services provided by utilizing expert knowledge of insurance... ...specific billing requirements Review balances post‑insurance to...Work at officeLocal areaRemote workWork from home
- The CareIQ Intake Specialist provides administrative customer service assistance to... ...receiving and entering new ancillary healthcare referrals. Utilizing proprietary systems and knowledge... ...environment Completes accurate data entry and review Able to learn and operate corporate...Minimum wageFull timeWork experience placementWork at officeLocal areaRemote workMonday to FridayFlexible hours
$68.5k - $88k
...issue resolution, and project support. Utilize strong organizational skills, attention... ...accuracy across documentation, content reviews, approvals, and project deliverables. Advanced... ...of performance and data solutions for healthcare facilities. We are a crucial link...Temporary workWork experience placementWork at officeLocal areaRemote workFlexible hours- ...Working with St. Elizabeth Healthcare At St. Elizabeth Healthcare,... ...hiring a Technical Denials Specialist! This position is remote after... ...resolve root cause issues, reviews and resolves technical denials... ...documenting actions taken. Utilizes all appropriate systems to effectively...Full timeContract workWork at officeLocal areaRemote workFlexible hoursDay shift
- ...of the Precertification Team Manager, the Utilization Management (UM) Specialist is responsible for managing daily non-clinical review activities that support the clinical,... ...works closely with internal departments, healthcare providers, hospitals, and provider office...Work experience placementWork at officeLocal areaRemote work
$49.6k - $74.41k
...the Job Welcome to Ovation Healthcare! At Ovation Healthcare (formerly... ...skilled subject matter specialists and operations executives, in... ...guidelines and regulations. Utilizes DDE, CWF, and other tools to... ...with Medicare or patients. Review patient accounts and reconcile...Hourly payFull timeTemporary workWork experience placementWork at officeLocal areaRemote workWork from homeFlexible hours$17.84 - $28.02 per hour
...properly in the contractual timeline. Supports utilization management team to document... ...documentation for services related to the members healthcare eligibility and access. Key Details:... ...guidelines Supports the authorization review process by researching and documenting necessary...Hourly payFull timePart timeH1bLive inWork at officeRemote workFlexible hours- ...providing solutions that help healthcare organizations provide high... ...challenges. Position: Sourcing Specialist JOB SUMMARY: Ensures the most... ...all purchase orders including, review of purchase orders and... ...affecting healthcare purchasing. Utilizes continuing education opportunities...Temporary workFlexible hours
$18.99 - $23.37 per hour
...Description The Revenue Cycle Specialist is responsible for... ...assigned Athenahealth worklists, reviewing patient accounts and determining... ...reconcile payment activity utilizing bank portals, payer portals,... ...one (1) year of experience in healthcare revenue cycle, medical...Work at officeLocal areaRemote work- ...Behavioral Health Technicians Pyramid Healthcare is dedicated to offering the... ...seeking a Certified Recovery Specialist (CRS) to support individuals... ...Use Disorder (OUD) . The CRS utilizes lived experience, recovery-... ...Assist in the development, review, and ongoing updating of...Work experience placementMonday to Friday
$18 per hour
Pyramid Healthcare is dedicated to offering the highest quality of... ...Summary: The Certified Recovery Specialist provides recovery-oriented... ...services. This role utilizes lived experience to assist clients... ...Prepare and complete concurrent reviews and communications with...Work experience placementShift workWeekend work$18.92 - $23.46 per hour
Recognized as a “Best Place to Work Modern Healthcare” - Join a team where people come first.... ...is 100% remote. 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 areaImmediate startRemote workFlexible hours$85.56k
...scientists equipped to address the healthcare needs of New York’s... ...is currently seeking a Legal Specialist. The successful candidate will... ...filing system for internal review and external production within... ..., reports, and summaries, utilizing such tools as Lexis Nexis Uni...Contract workWork at office
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare Utilization Review Specialist. Be the first to apply!
- eye specialist New York, NY
- reentry specialist New York, NY
- crisis specialist New York, NY
- technology integration specialist New York, NY
- deployment specialist New York, NY
- recovery specialist New York, NY
- qc specialist New York, NY
- parts specialist New York, NY
- crisis intervention specialist New York, NY
- traffic specialist New York, NY

