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- ...We are home to Nevada’s ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are... ...facility by ANCC, and we are on our journey to Magnet status. Review patient admissions for appropriateness, efficiency of resource...SuggestedWork at officeShift workWeekend work
$52.26 - $81.13 per hour
...Description The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing...SuggestedMinimum wageFull timeLocal areaShift work- ...with behavioral health providers to offer a full suite of administrative solutions, including comprehensive medical billing, utilization review services, and credentialing support. Our mission is to simplify the complexities of revenue cycle management, helping providers...Suggested
$71.61k - $111k
Utilization Review Nurse page is loaded## Utilization Review Nurselocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted on: Posted Todayjob requisition id: 69429Department/Unit:Care Management/Social WorkWork Shift:Day (United States of America)Salary...SuggestedRemote workShift work- Job No: 497118 Department: Medical Care Review Local Title: Utilization Review Nurse Budget Title: Teaching Hospital Quality Assurance Senior Coordinator Work Type: Full Time Location: Brooklyn, NY Categories: Administrative, Nursing, Patient Care Job Summary The...SuggestedFull timeReliefLocal areaMonday to Friday
$18 - $20 per hour
Utilization Review Coordinator Primary Purpose To assign utilization review requests; to verify and enter data in appropriate system(s); and to provide general support to clinical staff in a team environment. Are you an ideal candidate? We are looking for enthusiastic...SuggestedWork at officeLocal areaFlexible hours$54 - $66 per hour
We are recruiting for a Utilization Review Nurse to join a large healthcare organization within the Sacramento region. The Utilization Review Nurse is responsible for overseeing the daily operations of the UM Pre-Authorization team, ensuring referral requests are processed...SuggestedContract workWork at office$17.44 per hour
About the Position Tulsa Center for Behavioral Health is recruiting for a Utilization Review Specialist. The role involves reviewing clinical documentation to ensure admission appropriateness, continued stay criteria, and special studies related to care delivery and treatment...SuggestedHourly payFull timeWork at officeFlexible hoursWeekend work- ...ensuring clients receive timely and medically necessary care. Position Overview: We are seeking a detail-oriented, proactive Utilization Review (UR) Coordinator to support insurance authorization processes across all levels of care — including Detox, Residential, PHP,...Suggested
- ...expanding access to our unique model of care across the United States. NeuroPsychiatric Hospital of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring...SuggestedWork at office
- A leading healthcare provider is seeking a Full-time Utilization Review Coordinator in Columbia, South Carolina. This role involves precertifying and verifying benefits, coordinating caseload management, and collaborating with treatment teams. Candidates should have a...SuggestedFull time
- What We're Looking For We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker’s treatment are effective, efficient, and in accordance with applicable legal requirements. This is...SuggestedPermanent employmentFull timeWork at officeWork from home2 days per week
- ...and healing environment that improves patient outcomes and empowers patients toward long-term recovery. Position Summary The Utilization Review Specialist is responsible for managing all aspects of insurance authorization and concurrent review for assigned patients....Suggested
- ...re passionate about recovery and want to impact others in a meaningful way, we warmly invite you to join our growing family! Utilization Review Specialist (Corporate NJ Team) The Utilization Review Specialist collaborates with Avenues Recovery facilities regarding...SuggestedTemporary workFlexible hours
- ...Miami-Dade and Broward counties.The following Job Description will also apply at Broward Pace Program sites. Job Summary The Utilization Review Analyst supports the Florida PACE Centers’ UM Program by combining administrative expertise with analytical skills to...SuggestedFull timePart timeLocal areaShift work
- 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...
- ...providing evidence‑based outpatient and inpatient psychiatric treatment programs with successful outcomes. Position Summary: The Utilization Review Coordinator performs all functions related to the use of hospital resources and reimbursement. Utilization Review functions...Work at officeLocal area
$35.62 - $52.99 per hour
Job Summary and Responsibilities As our Utilization Review LVN, your focus will be to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. The LVN assists in determining...Contract work- Responsibilities Three Rivers Midlands is seeking a dynamic & talented Full-time Utilization Review Coordinator Three Rivers Midlands is a comprehensive behavioral health facility treating children and adolescents through residential and Rehabilitative Behavioral Health...Full timeLocal area
- Summary Of Position Assists the clinical staff with daily tasks, including ensuring the safety and welfare of all consumers, maintaining building safety and security, and providing general coverage and duties in support of the program's mission. Essential Responsibilities...Flexible hours
- A healthcare provider is seeking a Utilization Review Coordinator in Tennessee to ensure the safety and security of youth under care. The role involves managing patient care, performing clinical reviews, and ensuring adherence to reimbursement processes. Candidates should...Flexible 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...
- Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Qualifications Nursing school graduate. California Registered Nurse License upon hire. 3...Work at office
$73k - $75k
...Place to Work® Fortune Best Workplaces in Financial Services & Insurance PRIMARY PURPOSE To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates...Work at officeFlexible hours- Utilization Review Pharmacist Shape the drug benefit landscape—analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective...
- Overview Avalon Health Care Management is hiring a Case Manager of Utilization Management and Authorizations to join our team. This role... ...by managing authorizations, utilization management, concurrent review, and payor coordination while ensuring smooth transitions of...Full timeContract workTemporary work
$38.67 - $58.05 per hour
Job Requirements This role is full-time. Monday - Friday 8:00 am - 4:30 pm EST. Responsible for performing utilization management. Proactively review, identify and document potentially avoidable utilization and patient quality/efficiency concerns. Work collaboratively...Full timeWork experience placementMonday to Friday- A leading healthcare provider is seeking a Utilization Review Coordinator to manage patient care and ensure safety for youth. Candidates should have a background in nursing, social work, or psychology, along with psychiatric experience in chart analysis and utilization...Flexible hours
- ...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,...Contract workRemote workMonday to FridayFlexible hours
- ...Clinica Review Nurse Travel offering nursing profession RN specialty utilization review. Regular pay rate $63. Shifts per week 5. Scheduled hours 40. Start date 04/10/2026. End date 07/10/2026. Duration 13 weeks. City Uniondale, State NY, Zip Code 11556. RC HealthcareShift work