Clinical Utilization & Authorization Specialist
Regional Economic Community Action Program, Inc.
Regional Economic Community Action Program, Inc. is seeking a detail-oriented Utilization Review Specialist to ensure clinical services are medically necessary, authorized, and compliant with NY OASAS, Medicaid Managed Care, and payer guidelines. The role covers utilization management, clinical documentation review, revenue cycle support, and quality improvement across two NY-certified programs. The position requires collaboration with clinical staff, billing, managed care organizations, and #J-18808-Ljbffr Regional Economic Community Action Program, Inc.
- ...Community Action Program Inc seeks a dedicated Utilization Review Specialist to ensure services are medically necessary, properly authorized, and compliant with NY OASAS regulations... ...guidelines. You will collaborate with clinical and billing teams across two NYS-...Suggested
- ...Description POSITION SUMMARY The Utilization Review Specialist is responsible for ensuring clinical services are medically necessary, appropriately authorized, and compliant with applicable New York State Office of Addiction Services and Supports (OASAS) regulations, Medicaid...SuggestedSecond jobWork at officeLocal area
- ...Job Title Required Skills & Experience: Prior authorization experience within plastic surgery, radiology, or outpatient procedures. Experience working with out-of-network providers or gap exception requests. Experience supporting surgical or procedure-based authorization...SuggestedWork at office
$86.21k - $141.64k
...motivated individual to join our team as Lead Specialist, General Audit.This role will support... ...applicant, you must be legally authorized to work in the United States, without the... ...request an alternative process that does not utilize AI Tools or would like to request a reasonable...SuggestedFull timeH1bWork at officeVisa sponsorshipWork visaFlexible hours$25.77 per hour
...positive change. The Patient Access Specialist is responsible for all Inpatient and Outpatient... ...to receiving services. Verifies pre-authorization requirements and follows up with both... ...Management for timely submission of Clinical Information to payer. Verifies...SuggestedHourly payFull timePart timeApprenticeshipWork experience placementWork at officeShift workNight shiftRotating shiftWeekend workAfternoon shift- ...leader of positive change. The role integrates and coordinates utilization management, care coordination, discharge planning functions... ...Jersey (NJ) License, or Licensed Social Worker (LSW) or Licensed Clinical Social Worker (LCSW). Case Management certification by a...Full timeWork at office
- ...where the participant feels comfortable. The ACT Employment Specialist will utilize the evidence-based model of Individual Placement and... ...specific). Collaborate with the ACT Vocational Specialist and clinical staff. Perform additional assignments as determined by the...Work at officeLocal area
$20 per hour
...and young adults with psychosis. The Peer Specialist will work as part of the OnTrackNY team... ..., the Peer Specialist uses a non-clinical approach to support, empower, and advocate... ...and resources Influencing Team Culture: Utilizing lived experience and non-clinical approach...Work at officeLocal areaMonday to FridayAfternoon shift- Could you be our next Clinical Aide at Mirmont Treatment Center? Why work as a Clinical Aide? Make an Impact! In your role as a Behavioral Health Clinical Aide, you will be a key component of our team ensuring our patients have a Superior Patient Experience. Providing...Full timePart timeShift workWeekend workAfternoon shift
$40 - $50 per hour
...Veterinary Technician Specialist, Anesthesia VTS $40 - $50/hr. | +up to $10,000 SIGN... ...management, and complex disease processes, using clinical knowledge and experience to anticipate... ...potential anesthetic complications and utilize knowledge of physiology and disease...Full timeRelocationRelocation package$18 per hour
...all events being conducted in the store. Assists other Event Specialists with event kits, materials and tools as needed. Assist Supervisor... ...accurate and reasonable at the time of posting. Acosta Group utilizes E-Verify for validating the ability to work in the United...Hourly payPart timeLocal areaImmediate start- ...reliable and driven professional with strong relationship-building skills. Responsibilities: Communicate directly with customers, utilizing strategies to retain the business of existing customers Ensure a high level of customer satisfaction through proactive support...Full time
$20 per hour
...means to reduce stress and bond with their child. The Outreach Specialist is responsible for generating referrals for the Orange County... ...relationships with referral sources such as OBGYN, WIC, health clinics, hospitals and community based organizations. Outreach...Flexible hoursWeekend workAfternoon shift- ...Could you be our next Certified Recovery Specialist at Bryn Mawr Hospital? Why work as a Certified Recovery Specialist with Main Line... ...Shift- 8am-4:30pm Monday-Friday Experience One year of recent clinical experience in substance abuse treatment. 18 months of personal...Full timePart timeWork at officeMonday to FridayShift workDay shift
$50k - $60k
...CPC is looking for a full-time vocational specialist to work as part of a multi-disciplinary clinical team that will work in collaboration with the consumer in developing and executing a care plan with a holistic approach in our PACT Team in Red Bank, NJ. Job Title: Vocational...Full timeLocal areaFlexible hours$20.3 per hour
...Job Title: Life Skill Specialist Employment Type: Full-time, 40 hours per week Schedule: Monday-Friday, 8 AM-4:30 PM, 2 evenings of availability... ...: FREE robust training curriculum featuring our brand-new Clinical Training Series for interactive learning, practical skill...Permanent employmentFull timePart timeSeasonal workWork at officeLocal areaTrial periodMonday to FridayAfternoon shift$47.84k - $54.08k
...opportunities for growth and learning About the Role: As a Clinical Technologist, you’ll be a critical member of our team,... ...the pelvis and lower extremities. With a team of committed specialists, cutting-edge medical technology, and a patient-centric approach...Full time- ...Job Description Job Description We are looking for Clinical Assistants for a number of our locations in both part-time and full-time openings. Location: IVI RMA North America-openings in NJ-Springfield, Eatontown, Englewood, West Orange, Somerset and Basking Ridge...Daily paidFull timePart timeMonday to Friday
- ...seeking a detail-oriented and highly organized Credentialing Specialist to join our team. This position is responsible for managing all... ...certifications, malpractice coverage, and other required credentials. Utilize PECOS , CAQH , and other credentialing systems to manage...Full timeWork at office
- ...as the vital link between patients, providers, and insurers, ensuring a seamless care journey. You will verify coverage, obtain authorizations, coordinate referrals, and help optimize schedules to improve access to care. The role emphasizes HIPAA-compliant processes and...
- Hackensack Meridian Health is seeking a Certified Recreation Therapist to provide clinical services to clients, including assessments and treatment planning, with a focus on recreational and adjunctive therapy. You will collaborate with care teams to support patient well...
- ...leading home improvement retailer is seeking an Asset Protection Specialist in the City of Middletown, New York. The primary... ...fraud while supporting safety compliance. The specialist will utilize various tools to minimize loss, prepare detailed reports, and...
$50k - $65k
...continue to expand, we are looking for an experienced Provisioning Specialist to join our Global Professional Services team. In this role,... ...requests, evaluate business impacts, and exercise independent authority to approve, reject, or re-route non-standard requests. Cross-...Casual workWork at officeLocal areaRemote workWork from homeWorldwideHome officeFlexible hours- ...Facility surveys (inspections) made by authorized government agencies. Monitor the Facility... ...of the nursing needs of each resident, utilizing the forms required by current rules or regulations... ...document such action in the resident’s clinical record. Qualifications: Must possess a...
- Access: Supports for Living is seeking a clinical leader to supervise a team of mental health clinicians and drive quality patient care... ...clinician performance, coordinate with the CCBHC framework, and utilize EMR systems for reporting. A strong communicator with HIPAA...
$100k - $120k
...our team in Lincroft, New Jersey. This full-time position focuses on providing high-quality rehabilitation services in an outpatient clinic environment, where you will make a significant impact on patient recovery and overall well-being. The successful candidate will be...Full time$100k - $120k
...to enhancing the quality of life for our patients through comprehensive rehabilitation services. As a Physical Therapist, you will utilize your expertise to develop individualized treatment plans tailored to each patient's needs, engaging in evidence-based practices to...Full time$64.33k
Community Health Resources is seeking a Clinical Supervisor for its Youth Mobile Crisis Intervention Services in Middletown, NY. This full-time role involves leading a multidisciplinary team and providing crisis intervention services to clients. You will collaborate with...Full time$100k - $120k
...Preparing thorough documentation, including initial evaluations, therapy notes, and discharge summaries to maintain compliance with clinical records requirements. Engaging in interdisciplinary case conferences to collaboratively plan and evaluate comprehensive...Full timeFlexible hours$100k - $120k
...clients and their families regarding therapy routines, the use of assistive devices, and self-care practices. Contribute to the clinical documentation process, including completing evaluations, care plans, and progress notes accurately and promptly. Patient...Full timeTemporary work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Clinical Utilization & Authorization Specialist. Be the first to apply!
- clinical support specialist
- clinical specialist
- clinical data specialist
- ophthalmic clinical application specialist
- clinical intake specialist
- clinical applications specialist medical imaging
- clinical operations specialist
- entry level public health educator
- clinical nurse educator
- clinical education specialist





