Utilization Review Clinician (MSW) - Care Authorization
Universal Hospital Services Inc.
A healthcare provider in Sacramento, CA is looking for a Utilization Review Clinician responsible for managing patient care resources and ensuring optimal reimbursement. Candidates should have a Master’s degree in social work and experience with external review organizations. The position includes comprehensive benefits such as competitive compensation, healthcare plans, and career development opportunities. #J-18808-Ljbffr Universal Hospital Services Inc.
- ...Utilization Review Clinician Heritage Oaks Hospital is part of the UHS Family of... ...receive the optimal level of care that will be most... ...payor sources and receive authorization for the type and volume of... ...Management is preferred. Licensure: MSW degree Additional Requirements...SuggestedWork at officeLocal area
- ...receive the optimal level of care that will be most... ...recovery. Website: The Utilization Review Clinician is responsible for the managing... ...payor sources and receive authorization for the type and volume of... ...preferred. Licensure : MSW degree Additional Requirements...SuggestedWork at officeLocal area
- ...Your Role The Utilization Management Concurrent Review team reviews the inpatient stays for our members and... ...nationally recognized levels of care. The Utilization Management Concurrent... ...first level determination for authorization requests received for members using...SuggestedFull timeWork at office
$90.86k - $136.29k
...Job Title Utilization Management Concurrent Review Nurse Job Description The Utilization Management Concurrent... ...for nationally recognized levels of care. In this role you will perform first level determination for authorization requests received for members using...SuggestedFull timeContract workWork at officeRemote work$54 - $66 per hour
We are recruiting for a Utilization Review Nurse to join a large healthcare organization within... ...overseeing the daily operations of the UM Pre-Authorization team, ensuring referral requests are... ...a health plan, UM operations, acute care, or subacute utilization review...SuggestedContract workWork at office$26.41 - $51.49 per hour
...support for member clinical review processes specific to applied... ...through integrated delivery of care across the continuum.... ...Works collaboratively with the utilization and care management departments... ...disorders. ~ Approves prior authorization requests for BHT treatment by...Hourly payContract workWork experience placementWork at officeLocal area$45 - $50 per hour
...Utilization Management Nurse – Medicare Remote | California RN Required | Must sit in CA... ...ensuring medically appropriate, cost‑effective care while supporting safe and timely... ...concurrent, and retrospective utilization reviews for Medicare members Apply evidence‑based...Contract workTemporary workRemote workWork from home$35 - $45 per hour
...Position: RN / Utilization Review Nurse Location: Sacramento, CA (ON-SITE) Employment Type: Potential contract to hire Pay Range: $3... ...clinical documentation to support timely, accurate, and compliant care decisions in accordance with established guidelines and...Weekly payContract workWork at officeRemote workMonday to Friday$27.61 - $53.83 per hour
...for clinical member services review assessment processes. Responsible... ...integrated delivery of care across the continuum. Contributes... ...reviews to determine prior authorization/financial responsibility for... ...Molina care model. • Adheres to utilization management (UM) policies and...Hourly payContract workWork experience placementWork at office- Gilder Search Group is seeking an experienced Utilization Review Nurse for a potential contract to hire position in Sacramento, CA. The role... ...records and treatment requests to support timely and compliant care decisions. The ideal candidate will have at least 3 years of...Contract work
- Canon Recruiting Group is hiring an RN / Utilization Review Nurse for a potential contract to hire position in Sacramento, CA. This role involves... ...to ensure compliance with guidelines and provide timely care decisions. Applicants must have an active LVN license and at...Weekly payContract workMonday to Friday
- ...Staffing Solutions is seeking a Clinical Review Nurse for a remote position in California... ...grievances, medical necessity review, and utilization management. The ideal candidate will be... ...guidelines, and ensuring compliance in managed care settings. Responsibilities include...Remote job
- A-Line Staffing Solutions is seeking a Clinical Review Nurse in Alameda, California. The role is full-time... ..., grievances, medical necessity reviews, and utilization reviews. Candidates should have 3+ years of acute care experience and at least 2 years in appeals and grievances...Full time
$54 - $66 per hour
A prominent healthcare staffing agency is seeking a Utilization Review Nurse in Sacramento, CA, responsible for managing the daily operations of the UM Pre-Authorization team. The ideal candidate will ensure accurate processing of referral requests, maintain regulatory...- ...Hospital is seeking a Full‑time Utilization Management Coordinator (... ...location, a 171‑bed psychiatric care facility located in south... ...problems. Responsibilities Manage, review, and monitor the utilization... ...payor sources and receive authorization for the type and volume of services...Full timeWork at officeLocal areaShift work
$35 - $45 per hour
Canon Recruiting Group is seeking an experienced RN / Utilization Review Nurse in Sacramento, CA. The role involves reviewing medical records and treatment requests, ensuring compliance with clinical guidelines, and collaborating with internal teams. Candidates should...Contract work- Licensed Vocational Nurse /LVN - Utilization Review (HEDIS Abstractor) HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical...Private practiceWork at officeMonday to Friday
- ...Sacramento is seeking a Full-time Utilization Management Coordinator (... ...communication experience with external review organizations. A Registered... ...evaluating resources for patient care, liaising with payors, and obtaining service authorizations. Training in Crisis Prevention...Full time
- ...Your Role The Utilization Management team reviews inpatient stays and prior authorization for our members and correctly applies... ...nationally recognized levels of care for both our Medi-Cal and... ...will lead and support a team of clinicians to ensure safe, timely, and appropriate...Full timeWork at office
- ...The Behavioral Health Utilization Management team performs... ...concurrent utilization reviews and first level determinations... ...Utilization Management Clinician, Senior, will report to... ...and substance use authorization requests at various levels of care for medical necessity,...Full timeContract workWork at office
- ...Behavioral Health Utilization Management Clinician, Senior The Behavioral Health Utilization... ...& concurrent utilization reviews and first level determinations... ...mental health and substance use authorization requests at various levels of care for medical necessity, coding...Full timeContract workPart timeWork at officeLocal areaWork from homeHome office2 days per week
$71.1k - $97.8k
Become a part of our caring community Conviva Care Solutions is seeking a RN who will collaborate... ...with other health care givers in reviewing actual and proposed medical care and... ...care experience, DME, Florida Medicaid OR utilization management experience Ability to work...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome officeWeekend work- ...provider in California is seeking a Supervisor of Utilization Management to oversee operations of the Pre-Authorization team. This role requires 5+ years of clinical... ...work environment and focuses on improving patient care and operational efficiency. Join us in making a...Remote job
- Job Summary Coordinates quality, utilization and risk management activities for the medical center; provides technical, educational... ...objective assessment of important aspects of patient care through ongoing chart review with pre-established criteria. Reports all occurrences...Hourly payWork at officeLocal area
$147.89k - $187.04k
...Clinician (Float Pool - MD/DO, NP/PA) Are you a versatile... ...impact across various areas of care? Join our team at One... ...insurance, and, depending on volume, review of Motor Vehicle Record.... ...citizens and non-US citizens authorized to work in the United States...Hourly payLocal area$40.23 per hour
POSITION TITLE: Clinician REPORTS TO (TITLE): Director of Clinical Services Currently Hiring... ...supervision. About Sacramento Behavioral Health Care Hospital (SBHH) SBHH provides services... ..., and coordination with external review organizations preferred. Experience with...Daily paidTemporary workReliefCurrently hiringWork at officeShift workWeekend work$66 per hour
Clinical Review Nurse Location: Alameda, CA Pay: $66.00/hour Schedule: Full-Time, Monday-Friday, 8:00 AM-5:00 PM License... ...on appeals, grievances, medical necessity review, utilization review, and managed care clinical case evaluation . This role is ideal for an experienced...Full timeMonday to Friday- ...variety of services with respect to medical care review, cost containment, claims review,... ...statistical case reviews and generates utilization reports Examine DRG pre-certification... ...reports all information within scope of authority Performs analytical reporting from a...Work at office
$85k - $115k
...customer service. Hanger's Patient Care segment is the largest owner... ...several skillful technicians utilize the latest technology.... ...direction of one of our certified clinicians. You will enjoy combining... ...other referral sources to review prosthetic and/or orthotic services...Part timeSummer workLocal areaRelocation packageFlexible hoursDay shift$200k
...comprehensive, patient-centered care to our nation's Veterans. As... ...(EHR) documentation. Utilize critical thinking skills to anticipate... ...Recruitment Incentives: Not Authorized EDRP Authorized:... ...Services program office after review of the EDRP application. Former...Permanent employmentFull timePart timeWork at officeRemote workRelocation package
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