Utilization Review Specialist I
$17.44 per hourOklahoma Department of Mental Health and Substance Abuse Services
Utilization Review Specialist I Position is located at Tulsa Center for Behavioral Health – Utilization Review Department. The role involves reviewing clinical documentation for admission appropriateness, continued stay criteria, special studies, and coordinating authorizations and re‑certifications with external reimbursing entities. Job Type / Salary Open/Close dates: 6/17/2026 – until filled Full‑time Hourly rate: $17.44 Primary working hours: 8:00am-4:30pm FLSA Status: Non‑Exempt Primary work location/department: Tulsa Center for Behavioral Health – Utilization Review Dept Vacancies: 1 Minimum Qualifications and Experience Bachelor’s degree or four years of technical clerical, administrative, secretarial, or general office work; or an equivalent combination of education and experience. Preference for candidates with experience in social work, psychology, or a psychiatric setting. Special Requirements Must pass an OSBI background check. Must have a valid driver’s license and be willing to travel for job‑related duties. Benefits Generous state paid benefit allowance for insurance premiums. Wide choice of health insurance plans with no pre‑existing condition exclusions. Flexible spending accounts for health care or dependent care. Employee assistance programs and health and fitness programs. 11 paid holidays. 15 days of vacation and 15 days of sick leave the first year. Retirement savings plan with a generous match. Longevity bonus for years of service. Student loan repayment options. Training opportunities for CEU requirements. Other Information Work hours and location may vary depending on business necessity. Employees may be required to work weekends and overtime. Agency requires 24‑hour coverage, 7 days per week. Reasonable accommodation for individuals with disabilities may be provided upon request. Equal Opportunity Employer The State of Oklahoma is an equal opportunity employer and does not discriminate on the basis of genetic information, race, religion, color, sex, age, national origin, or disability. #J-18808-Ljbffr Oklahoma Department of Mental Health and Substance Abuse Services
$39.4 - $53 per hour
...license Must be available to work Monday - Friday, 8am - 5pm Central Time and every other weekend We are seeking Virtual Utilization Review Specialists to join our team. Resource Utilization Utilizes proactive triggers (diagnoses, cost criteria, and complications) to...SuggestedTemporary workWork at officeLocal areaRemote workMonday to FridayWeekend work- ...collective efforts will shape a healthier future for the communities we serve. How you’ll contribute How you’ll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine...SuggestedTemporary workFlexible hours
- UofL Health is seeking an RN for Utilization Review in Louisville, KY. The role supports the Utilization Management process, reviews medical necessity, and coordinates care across interdisciplinary teams to ensure appropriate utilization and patient outcomes. The ideal...Suggested
- ...BlueCross BlueShield South Carolina subsidiary, seeks a Medical Reviewer II (RN) to perform medical claim reviews and determine medical... ...guidelines. The role documents decisions and supports utilization review across multiple services. The position is remote, full-...SuggestedRemote jobFull time
$21.97 per hour
Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This position is responsible for various utilization review support, from initial insurance verification through authorization; including verifying patient benefits and authorization requirements, requesting...SuggestedFor contractorsWork at officeLocal area- ## Utility Project Support Specialist (Field Based)Applylocations: Rolling Meadows, Illinois: Kankakee, Illinoistime type: Part timeposted on: Posted... ...Please submit your resume and brief cover letter. Based on review of these responses, shortlisted candidates will be...Part timeFixed term contractCasual workRemote workShift work
- Capital Health seeks an experienced Utilization Review Supervisor for 40 hours/week in Trenton, NJ. The role oversees UR staff, ensures compliant reviews, and collaborates with physicians, finance, and ED teams to optimize care and cost efficiency. Requirements include...Full time
- Recovery Council, Inc. seeks an UM Specialist to support prior authorization, medical billing, utilization review (UR) and patient access for behavioral health and addiction services. Strong ASAM criteria knowledge and DSM-5/ICD-10 familiarity are required to validate...
- Environmental Resources Management (ERM) is seeking a remote Utility Project Support Specialist to assist our client in the Danville, IL area. This remote, part-time role operates 20 hours per week with a 12-month term, extendable, and focuses on handling inquiries related...Remote jobPart time
$75k - $90k
...accommodation or an alternative application process. Clinical Reviewer - Portland, Oregon 5 days ago Requisition ID: 1126 Salary... ...electronic medical record system; apply evidence-based criteria to utilization management reviews; document clinical determinations; provide...Full timeContract workRemote workWork from home- ...****@*****.*** Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening. To apply for the position, please click the Apply for this Job link/button. If you would like to bookmark...Full timeWork experience placementWork at officeLocal areaMonday to Friday
- ...Job Title: A/R Specialist Department: Revenue Cycle Management Reports to: A/R Manager FLSA Status: Non-Exempt Dental Account Receivable... ...managing accounts receivable, prioritizing account reviews and utilizing time management skills. Assists team members as needed with...Full timeContract workTemporary workPart timeWork at officeRemote workFlexible hours
- ## Medical Reviewer II - Palmetto GBAApplyremote type: Remotelocations: ****@*****.*** South Carolina: ****@*****.*** Alabama: ****@*****.*** Tennessee: ****@*****.*** Georgiatime... ...guidelines. Provides support and review of medical claims and utilization practices.# **Description****Logistics:** **Logistics:** ** **...Full timeFor contractorsWork experience placementLive inWork at officeLocal areaWork from homeHome officeMonday to FridayShift work
- City of Richardson Texas is seeking a Facilities Specialist - Utility Systems (Full Time) to maintain and operate critical water and wastewater infrastructure. The role requires a High School Diploma or GED, a Texas Class C driver license, and a competency certificate...Full time
- ...and drop ship orders, acting as a bridge between customers and vendors to ensure production readiness and on-time delivery. You will review artwork, engage with customers via phone and email, and provide exceptional service. Prior experience in customer service and...
- ...so, let's start the conversation. Job summary As a Document Review Specialist, you'll be responsible for the comprehensive review, management... ...and regulatory requirements. Inventory System Proficiency: Utilize our inventory management systems and handheld scanning...Local areaRelocationMonday to Friday
$20.98 - $30.12 per hour
...maximum level of cash to reduce receivable. Follows up with insurers to recover inaccurate payments. Reviews accounts to ensure accuracy of billing/charging utilizing knowledge of pre-certification /prior authorization procedures to validate account status. Resolves any...Immediate startRemote work$19 per hour
...Director) with administrative and non-clinical tasks related to processing Utilization Management prior authorization sand 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$40k - $52.3k
## Utilization Management CoordinatorApplylocations: Remote Ohiotime type: Full timeposted on: Posted Todayjob requisition id: R-426423#... ...service telephone experience desired* Experience with Utilization Review and/or Prior Authorization, preferably within a managed care...Weekly payFull timeTemporary workApprenticeshipRemote workHome office$145.6k - $270.4k
...position.The Rheumatology Institutional Specialist (IS) will be responsible for ensuring... ...rheumatology brands to help drive appropriate utilization of approved products.Increase demand by... ..., and upon joining Novartis will be reviewed periodically. Novartis may change the...Full timeLocal areaRemote workHome officeVisa sponsorshipRelocation package- CorVel Corporation seeks an Itemization Review Nurse to analyze charges on UBIB submissions for accuracy. This remote role requires RN licensure in the applicable state and 5 years of OR/ICU/ER experience. Responsibilities include data collection, documentation in the...Remote job
- UnitedHealth Group is seeking a licensed psychologist to perform peer review for Commercial, Medicaid, and Medicare cases, determining coverage decisions and treatment modifications as required. The role supports remote work from NY, NJ, or CT with engagement in peer consultations...Remote job
- POSITIO N: Analyst, Utility Billing Operations (Full Time, Exempt) REPORTS TO: Manager, Utility Billing Operations COMPENSATION: Pursuant... ...to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-1...Full timeWork at office
- ...Position Title Specialist Distribution and Logistics Great Bend Hospital Position Summary... ...requisitioned by various departments. Proactively review schedules and patient census to foresee... ...and orders accordingly. Maintains, utilizes and adheres to Group purchasing...Full time
- ...Intelligence Specialist Under general supervision, the selected candidate will be responsible for the following... ...interviews of subjects and witnesses, and writing and reviewing lengthy, narrative reports - Utilizing various databases and web-based programs to verify...Full time
$176.72k - $265.08k
...seeking a highly skilled and experienced KDB+ Specialist to be a key contributor to the strategic... ...discussions and conduct rigorous code reviews to ensure high quality, performance, and... ...-performance, low-latency applications utilizing KDB+/Q for our Equities Electronic...Full time- ...Position Overview The Order Management Specialist oversees all aspects of order management... ...linked to open installation service tickets Utilize business applications such as NetSuite,... ...Assist with special product orders Review NetSuite Opportunities pending signed contracts...For contractorsWork experience placementWork at officeLocal areaRemote work
- ## Fleet Safety Specialist 3Applylocations: Fredericktown, OHtime type: Full timeposted on... ...such as highways, bridges, underground utilities, water/wastewater facilities, and... ...system (e.g., Samsara, Samba Safety), reviewing triggered events like hard braking, speeding...For contractorsImmediate startNight shift
- ...Behavior Intervention Specialist Under the supervision of the Family Care Coordinator,... ...initial and annual assessment/evaluation reviews, annual clinical trainings, behavior support... ..., unplanned and planned contingencies) utilizing baseline procedures and formulating a...Full timeWork at office
- ...Establishes both proactive and reactive data collection methods and reviews data at least monthly. Behavioral support plans will be... ...of a Level 1 BIS.Any behavior support plans or services which utilize restrictive/intrusive interventions must be developed under the...Work at officeFlexible hoursNight shift
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