Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Healthcare Utilization Review Specialist

$20 - $30 per hour

Guidelight 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

Vacancy posted 1 day ago
Similar jobs that could be interesting for youBased on the Healthcare Utilization Review Specialist in New York, NY vacancy
  • $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... 
    Suggested
    Hourly pay
    Part time
    For contractors
    Work at office
    Remote work
    Flexible hours

    24-MAG LLC

    New York, NY
    2 days ago
  • 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... 
    Suggested
    Shift work
    Weekend work

    100 LCMC Health

    New York, NY
    4 days ago
  • 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... 
    Suggested
    Full time

    phoebehealth

    New York, NY
    2 days ago
  •  ...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... 
    Suggested
    Contract work
    Fixed term contract
    Work at office
    Remote work

    US Tech Solutions

    New York, NY
    4 days ago
  • 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... 
    Suggested

    NeueHealth

    New York, NY
    1 day ago
  • $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 employment
    Full time
    H1b
    Local area
    Remote work
    Visa sponsorship
    Work visa
    Relocation package

    Pfizer

    New York, NY
    9 hours ago
  • 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-... 
    Remote job
    Full time
    Monday to Friday

    CVS Health

    New York, NY
    3 days ago
  •  ...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 office
    Local area
    Trial period

    MetroPlusHealth

    New York, NY
    9 hours ago
  •  ...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 time
    Work experience placement
    Work at office
    Monday to Friday

    Transformcap

    New York, NY
    4 days ago
  •  ...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 office
    Shift work

    Socket

    New York, NY
    5 days ago
  •  ...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 area
    Remote work

    RXinsider

    New York, NY
    2 days ago
  •  ...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 work
    Monday to Friday

    OSS Health

    New York, NY
    4 days ago
  • 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

    Trillium-Health-Resources

    New York, NY
    5 days ago
  • $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 job
    Temporary work
    For contractors
    Work at office
    Local area

    Highmark Health

    New York, NY
    4 days ago
  •  ...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... 
    Relief
    Work at office
    Local area
    All shifts
    Monday to Friday
    Flexible hours
    Day shift

    Universal Hospital Services Inc.

    New York, NY
    20 hours ago
  • $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 office
    Immediate start
    Remote work
    Work from home
    Flexible hours

    Trillium-Health-Resources

    New York, NY
    5 days ago
  •  ...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 job
    Local area
    Flexible hours
    Shift work

    M3 USA

    New York, NY
    2 days ago
  • 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 office
    Remote work

    nTech Workforce

    New York, NY
    2 days ago
  • $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

    Sprinter Health

    New York, NY
    4 days ago
  • $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 wage
    Full time
    Contract work
    Work at office
    Local area
    Immediate start
    Remote work
    Flexible hours
    3 days per week
    1 day per week

    Marsh

    New York, NY
    4 days ago
  •  ...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 employment
    Full time
    Work at office
    Immediate start
    Flexible hours

    Amperos

    New York, NY
    9 hours ago
  • $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 wage
    Work at office
    Local area
    Remote work
    Flexible hours
    3 days per week
    1 day per week

    Marsh Risk

    New York, NY
    1 day ago
  • $91.7k - $163.7k

    UnitedHealth Group seeks a licensed psychologist to perform peer review for Commercial, Medicaid, and Medicare cases, shaping treatment coverage and ensuring compliance with criteria. You will handle outpatient and intensive services, testing requests, and appeals. Residents... 
    Remote job
    Full time

    MIMH Professional Training

    New York, NY
    2 days ago
  • $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 time
    Live in
    Local area
    Relocation package
    Night shift
    Weekend work
    Afternoon shift

    Genentech

    New York, NY
    3 days ago
  • $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 pay
    Full time
    Temporary work
    For contractors
    Relief
    Local area
    Remote work
    Work from home
    Monday to Friday

    Guidehealth

    New York, NY
    5 days ago
  •  ...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... 

    Confidential

    New York, NY
    1 day ago
  • $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 pay
    Daily paid
    Traineeship
    Local area

    Mount Sinai Health System

    New York, NY
    1 day ago
  • 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

    ISHE

    New York, NY
    2 days ago
  • 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

    Okpsych

    New York, NY
    2 days ago
  • $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 time
    Work experience placement
    H1b
    Work at office
    Local area
    Immediate start
    Remote work
    Worldwide
    Flexible hours
    Night shift

    Medtronic

    New York, NY
    9 hours ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Healthcare Utilization Review Specialist. Be the first to apply!