Utilization Review Specialist
Santa Barbara Cottage Hospital
Humana Healthy Horizons in Kentucky seeks a Utilization Management Behavioral Health Professional 2 to support coordination, documentation, and communication of medical services and benefit determinations. The role requires interpreting criteria and policies with independent judgment. Requirements include Kentucky residency (or contiguous counties), a nursing degree or a master's in Human Services with licensure, and 3+ years of post-degree clinical experience. #J-18808-Ljbffr
$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- ...Coronis Health is seeking a remote Utilization Review Specialist to manage treatment authorization for behavioral health and substance abuse, interfacing with insurance and managed care entities. The role covers pre-certification, concurrent reviews, and appeals with a...SuggestedRemote work
$50k
...the lives of patients and their families What to Expect (Job Responsibilities) Complete pre-authorizations, concurrent reviews, and internal utilization review assessments Consult with the multidisciplinary treatment team to gather necessary information for concurrent...SuggestedRemote work- ...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
$56.97k - $84.75k
Work From Home Work From Home Work From Home, Indiana 46544 The Utilization Review Coordinator performs admission screening for patients in a bed for medical necessity, and reviews for appropriateness of setting and utilization. WHO WE ARE With 11 ministries and...SuggestedFull timeWork at officeLocal areaWork from homeMonday to Friday$20 per hour
...Results Expected: Perform admission, continued stay and discharge reviews on all managed care clients. Maintain positive relationships... ...level, Word- Intermediate level. 3-5 years’ experience in Utilization Review or related position in a healthcare setting. Job-...Full timeWork at officeLocal areaFlexible hours$20 - $30 per hour
...the behavioral health industry by delivering exceptional care, utilizing state-of-the-art facilities, and prioritizing the well-being of... ...: Exempt Travel Requirement: None Responsibilities Utilization Review on Behalf of the Clinics: Prescreen referrals to project/anticipate...Remote work- ...Position: Case Review Specialist – Phone Intake & Documentation Location: Remote Remote Status: Remote Job Id: 1678 # of Openings: 1 About... ...degree. Minimum 2 years of experience in healthcare operations, utilization management, case management, intake, call center, or related...Work at officeLocal areaRemote workMonday to FridayShift work
$122.91k - $188.02k
Healthfirst is seeking a Medical Peer Reviewer based in Pennsylvania to evaluate medical necessity as part of utilization management. The role requires collaboration with various medical departments and demands flexibility in workload. The hiring range is $122,907 to $1...- ...employees. Responsibilities Empower AI: As a casual Medical Review Specialist III (Medical Reviewer III) for Empower AI, Inc., you will... ...payment determinations based on Insurance coverage, coding, and utilization of services and practice guidelines for Medicare DME....For contractorsCasual workWork at officeLocal area
$32 per hour
...are valued and respected. We have an ongoing need for Document Reviewers. Document Reviewers will review documents for complex... ...Android OS version 16 or later is required. Proficiency in utilizing modern technology, especially computers and related remote work...Hourly payTemporary workRemote workWork from homeHome officeMonday to ThursdayFlexible hours$60 - $75 per hour
...Hmong Chinese Language Document Reviewer Employment Type: Full Time, Mid-Level Department: Legal As a CGS Hmong Chinese Document Reviewer... ...; - Produces a variety of written documents and materials utilizing a wide range of office software applications; - Establishes and...Full timeWork at officeFlexible hours- A legal services provider is looking for a Hindi Document Reviewer to handle remote document review tasks. Responsibilities include conducting privilege and responsiveness reviews, and utilizing electronic document review technologies. Candidates should be fluent in Hindi...Remote jobFlexible hours
- ...Responsibilities Black Bear Lodge Utilization Management Coordinator Foundations Recovery Network (FRN) is the premier provider of integrated... ...Qualifications Essential Duties and Responsibilities Reviews and understands insurance information provided by the Call Center...Work at officeLocal area
- ...Description The Provider Enrollment Specialist will be responsible for coordinating the... ...government and commercial payors. They will also review provider credentialing and/or... ...and maintains applicable matrices and/or utilizes departmental software that supports the...Work at officeRemote workFlexible hours
$19 per hour
...Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization and appeals. JOB RESPONSIBILITIES Monitor incoming faxes Enter UM authorizations review requests in UM platform using ICD-10 and HCPCS codes Verify...Temporary workLocal areaRemote work- ...Qualification (C&Q) activities for plants and equipment. Develop, review, and maintain commissioning and qualification procedures and... ...C&Q protocols and reports for various systems, including HVAC, utilities, production equipment, and lab equipment . Execute commissioning...Remote work
- Obsidian is hiring expert Evaluators in Special education/IEP to review AI-generated work products for accuracy and rigor. This is a remote, hourly engagement where you will apply your deep subject-matter expertise to grade outputs. Candidates must possess at least 5 years...Remote jobHourly payWork at office
$30 - $38 per hour
...A leading eDiscovery service provider is seeking a highly motivated Lead Document Reviewer. This remote position involves managing complex document review engagements, providing strategic leadership, and guiding a team of attorneys. Candidates should have a JD degree...Hourly payRemote work$17.25 - $20.5 per hour
...speak clearly and hear the spoken word well. Regularly required to utilize near vision ability to read data and documents, including... ...demands and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the agency at the...Hourly payWork at office- ...and conduct safety inspections. Job Duties and Responsibilities Reviews employee work processes in field settings and assesses safety... ...knowledge of Microsoft Office Suite. Experience with a wide variety of utility tasks and settings, preferably including both primary and...Work at officeLong distanceNight shift
- ...it’s safe.**Position Summary**The Safety Specialist will develop and monitor safety and... ...primary contact on health and safety issues.* Review and analyze incidents and claims to... ...nationwide. Our brands include Armstrong Utilities, Guardian Protection, Armstrong Development...For contractorsWork experience placement
- ...Osmose Utilities is seeking to fill multiple Safety Specialist1 roles; must live in one of... ...growing company and safety team, the Safety Specialist I will work/travel within their assigned... ...in pre-project planning and safety reviews to identify hazards, risks, requirements...For subcontractorLive inNight shift
$64.35k
...of BIS leadership, Behavior Intervention Specialists (BISs) perform clinical duties relating... ...Analyzes data from multiple sources and utilizes findings to conduct research on related... ...in interdisciplinary meetings and case reviews, including scheduled Person-Centered meetings...Full timeReliefMonday to FridayFlexible hoursAfternoon shift$70k - $72k
...Position Summary The Behavior Intervention Specialist I (BIS I) works in conjunction with the... ...ISP, Day Programs, Departmental, Case Reviews, Special IDT, Consult Reviews, and staff... ...three years or more frequently as needed. Utilize formal and informal assessments to...Hourly payFlexible hours- ...Experience Above". cb20 won the Albany Business Review Best Places to Work and Albany Times... ..., and commissioning of system solutions utilizing Field Commissioning Reports Perform end-... ...Provide technical guidance to junior specialists in their assigned job duties Required...
- ...Job Title: Paid Ads Specialist Position Type: Full-Time, Remote Working Hours: U.S. Business... ...execution, and optimization. You will: Review campaign performance metrics and adjust... ...Conversion Rate Ad Spend Efficiency and Budget Utilization Overall Campaign ROI and Growth over...Full timeRemote work
$28.09 - $35.08 per hour
...Will Do Interacts directly with provider offices, clinics, and other healthcare facilities on the retrieval of medical records for review and abstraction pertaining to HEDIS/QARR/Risk Adjustment and other focused audits/studies. Provides guidance on protocol as required...Work experience placementWork at officeLocal areaFlexible hours$75k - $85k
...Safety Specialist – ComplyAuto Join to apply for the Safety Specialist role at ComplyAuto.... ...exceptional benefits, we are excited to review your application! Remote/Travel This position... ...dealers rectify safety violations and utilizes this expertise to aid the sales team in...Full timeWork experience placementWork at officeRemote workWork from homeWork visa- ...Position:**This position serves as Valmont’s Specialist, Environmental, Health & Safety,... ...programs* Supports serious post incident reviews at their site, communication of incidents... ...to move about the office. Incumbent must utilize proper ergonomic safeguards such as monitor...Temporary workWork at officeLocal areaRemote work
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