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$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$55 per hour
...Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare... ...: Experience in case management, utilization management, or discharge planning. Experience... ...Nurse, Out-Patient Case Manager Travel Pediatric ICU Registered Nurse - $840 per week...SuggestedFull timeContract workTemporary workLocal areaRemote work- Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical... .... Every day, you will meticulously review medical records, authorize services, and... ...emergency centers offering adult and pediatric care for the Greater Houston area. #J-1...Suggested
$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- ...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
- ...coast. We are driven by a profound commitment to prioritize your well‑being so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier®. Join us on this...SuggestedFull timeTemporary workPart timeMonday to FridayFlexible hours
- ...knowledge of local and national coverage determinations Recent work experience in a hospital or insurance company providing utilization review services Knowledge of Medicare, Medicaid, and Managed Care requirements Progressive knowledge of community resources, health...SuggestedPermanent employmentWork experience placementLocal area
$17.44 per hour
Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E. - Integrity, Compassion, Accountability, Respect, and Excellence. Our mission is to promote healthy communities and provide the highest quality care to enhance the well‑being...SuggestedHourly payFull timeWork at officeFlexible hoursWeekend 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...SuggestedFull timeLocal areaShift work
- Overview Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote About Exact Billing Solutions Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental...SuggestedWork at officeRemote workFlexible hours
- ...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...SuggestedFull timeContract workRemote work
$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- 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
- ...admission through discharge. Serves as liaison to on-site external reviewers. Uses Midas for recording reviews and tracking denials. Adds... ...in applicable field of study required Six months psychiatric utilization review either for hospital or external review organization...SuggestedLocal areaFlexible hours
- Description Job Summary The UR Coordinator’s primary responsibility is managing, reviewing, and monitoring utilization of patient resources and obtaining payor authorization as required for all provided services. The UR Coordinator will function as liaison between payor...SuggestedTemporary workWork at officeLocal area
- Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside... ...evaluate members’ clinical conditions through medical record review to determine medical necessity for services. Using advanced clinical...Immediate startRemote workDay shift
$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 and...Full timeLocal areaShift work- Position Overview This Utilization Review role is primarily responsible for accurate data entry and administrative support, including patient scheduling and registration via phone and computer systems. The position also plays an important front‑line role in client engagement...
- ...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
$34.05 per hour
Job Details Job Location: Leesburg, FL 34748 Position Type: Full Time Salary Range: $34.05 Job Shift: Day Job Purpose The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that...Full timeTemporary workLocal areaFlexible hoursShift 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
- 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...Full timeReliefLocal areaMonday to Friday
- ...online at: Via Linda Behavioral Health. Position Description The Utilization Management Coordinator reports to the Utilization Management... ...services. Interface with managed care organizations, external reviewers, and other payors for initial reviews, continued stay reviews...Daily paidReliefWork at officeLocal areaShift workWeekend 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...Day shift
- ...growth‑focused business model, strong finances, and expert management team, Praesum will continue to grow in the years to come. Utilization Review Specialist Job Description Perform duties to authorize and review utilization of mental health and substance abuse services...Hourly payFull timeWork at officeVisa sponsorshipWeekend work
- 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...
- ...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
- Job Title Job Description Avenues Recovery
- ...Emory Healthcare Utilization Review Specialist Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs...Work at officeRemote work
- ...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