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- A leading healthcare provider is seeking an experienced Utilization Review Coordinator to join their team in Reno, Nevada. This role involves compiling clinical documentation and performing reviews to ensure the necessity of treatment. The ideal candidate has three years...Suggested
- ...Nevada's ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and... ...journey to Magnet status. Position Summary Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third party payer requirements...SuggestedWork at officeShift workWeekend work
$71.61k - $111k
Utilization Review Nurse page is loaded## Utilization Review Nurselocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted... ...to the region’s largest hospital, only Level 1 adult and pediatric trauma centers, and only children’s hospital. The downtown campus...SuggestedShift work- Responsibilities Utilization Review (UR) Coordinator - Full‑Time Daytime position. Calvary Healing Center has served the Phoenix area and nationwide for over 60 years, specializing in addiction treatment for adults. The flagship Phoenix location offers detoxification...SuggestedFull timeLocal area
- The Inpatient Behavioral Health Social Worker in Utilization Review is responsible for evaluating the medical necessity, appropriateness, and efficiency of behavioural health services provided to patients in an inpatient setting. This role ensures compliance with regulatory...Suggested
$28.85 - $31.25 per hour
...care and long-term care needs for medical necessity Perform case reviews and complete all required documentation in appropriate... ...72-hours for weekend) Provide outpatient or pharmacy services utilization review Qualifications 3+ years in recent medical/surgical or critical...SuggestedPrivate practiceWeekend workWeekday work- ...and chemical dependency related illnesses. / Job Summary Three Rivers Midlands is seeking a dynamic & talented Full-time Utilization Review Coordinator. Key Responsibilities The Utilization Review (UR) Coordinator provides pre-certification and verification of benefits...SuggestedFull timeLocal area
$35 - $40 per hour
Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of home health...SuggestedContract workRemote workFlexible hoursWeekend work$65 per hour
...coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while maintaining high-quality patient... ...care planning and discharge planning. Conduct utilization review to ensure appropriate level of care and services. Collaborate...SuggestedHourly payWeekly payLocal areaShift work$17.44 per hour
Agency 452 MENTAL HEALTH AND SUBSTANCE ABUSE SERV. Job Posting Title Utilization Review Specialist I Supervisory Organization Tulsa Center Behavioral Health Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is...SuggestedHourly payFull timePart timeWork at officeFlexible hoursWeekend work- Summary In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day shift, 7am- 3:30pm, Monday- Sunday every other week. Summary The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews...SuggestedDay shift
- ...regulatory timelines Collaborate with multidisciplinary teams Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing clients' members with...SuggestedContract workRemote work
- ...plan of care for members based on authorization and concurrent review. Provides monthly telephonic outreach to ensure members needs are... ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards,...SuggestedContract workRemote workMonday to FridayFlexible hours
- ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately... ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,...SuggestedPrivate practiceImmediate start
- ...faxing discharge clinical information Accurately enter information into the UR spreadsheet Schedule and follow up on peer-to-peer reviews Assist the UR Manager with data reporting as directed Ensure all Medicare certification letters are signed by the appropriate provider...SuggestedPart timeWork at officeFlexible hours
- ...that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff. Website: The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical...
- ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,... ...in acute clinical care Experience with medical record review/utilization review/utilization management Additional Information Are you...Contract workPrivate practiceMonday to Friday
$30 - $32 per hour
...conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Registered Nurse with Utilization Review or Concurrent Review experience looking for a new opportunity with a prestigious Managed Care Company? Do you want the chance...Private practiceWeekend workWeekday work- ...through all levels of care in the substance abuse and mental health setting. Works with the UR Director and facility contacts on case reviews for pre-service, concurrent, and retrospective authorizations and appeals, looking for medical necessity and appropriateness of...Full timePart timeRemote work
- Under direction, to review, monitor and assess utilization of hospital services; to administer Utilization Review procedures as required under federal, state, and county regulations as well as Valley Medical Center's Utilization Review plan or Public Health CCS guidelines...
- ...medical necessity and appropriateness of the treatment plan . This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from...Full timeContract workRemote work
- Responsibilities Utilization Review Coordinator PRN/Per Diem Weekend Shifts Via Linda Behavioral Hospital is a behavioral health provider serving Scottsdale and the greater Phoenix area. We opened in February 2022 and now offer a full continuum of inpatient and outpatient...Daily paidReliefWork at officeLocal areaShift workWeekend work
$4,801.16 - $7,761.5 per month
...advancement, and more. Benefits of Working at HHS webpage contains additional details. Position Details Functional Title: Utilization Review Nurse Job Title: Nurse II Agency: Health & Human Services Comm Department: UR Wav & Comm Srvs Ran Mmt St Posting Number:...Full timeTemporary workPart timeWork at officeRemote workShift work- ...direct clinical experience in a psychiatric or mental health setting Experience in treatment planning and communication with external review organizations or comparable entities Valid fingerprint clearance card Completion of BLS & First Aid certification within 30 days...Full timeLocal areaShift work
- ...want to impact others in a meaningful way - we warmly invite you to join our growing family! We are currently seeking to hire Utilization Review Specialists to join our corporate NJ Team! The Utilization Review Specialist collaborates with Avenues Recovery facilities...Temporary workCurrently hiringFlexible hours
- ...success. Job Description • Responsible for conducting timely reviews of all requests for services required to meet medical necessity... ...providers against plan review criteria and benefit guidelines • Utilizes clinical information to determine if criteria for medical necessity...
- ...compact) ) Employment Type: 4-month contract with possibility of extension Overview We are seeking an experienced Inpatient RN Utilization Reviewer to independently manage a clinically complex inpatient caseload across multiple care settings, including acute, subacute,...Daily paidContract workRemote workShift workWeekend work
$24 - $56.17 per hour
A prominent healthcare provider based in New York is seeking a professional to provide support for clinical member services review processes. The role involves ensuring services are medically necessary and compliant with established guidelines. Candidates should possess...Hourly payWork at office$80.2k - $125.6k
...supports our members, customers and the communities that we serve through our Healthsource blog: We have an opening for a Utilization Review Nurse ! The Utilization Review Nurse performs prospective review (benefit advisory/ prior authorization) admission, concurrent...Work experience placement- ...ensuring our patients receive the optimal level of care that will be most beneficial to their health and recovery. Website: The Utilization Review Clinician is responsible for the managing, reviewing and monitoring the utilization of resources related to the patient and...Work at officeLocal area