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$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- 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
- ...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
$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$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- 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
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving...SuggestedWork at officeLocal area
$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$76k - $85k
...challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing a medical management software system on a day-to-day...SuggestedFor contractorsH1bWork at officeLocal areaRemote 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
- ...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
- Job Title: Utilization Review Specialist Job Type: Full Time (FT) Your Experience Matters At Cottonwood Springs, we are committed to empowering and supporting a diverse and determined workforce that can drive quality, scalability, and significant impact across our hospitals...SuggestedFull timeTemporary workFlexible hours
- ...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
$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- ...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
- ...appropriateness of the treatment plan in the context of insurance or managed care. Qualifications Required: RN with IL Active License, with Utilization experience; familiar with MCG and ASAM criteria. Preferred: Inpatient hospital experience or ER background. Seniority level Mid-...Contract work
- 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
- ...employment)* Employer-paid Accident & Life Insurance (eligible after 60 days of employment)**Job Description:** The role of the Utilization Review Coordinator is to implement the organization’s Utilization Review (UR) process to ensure appropriate usage of available...Full timeRemote work
- 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...Full time
- 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...
- RBHN is looking for a Utilization Review Specialist to join our team of healthcare professionals. The Utilization Review Specialist is responsible for reviewing and evaluating clinical documentation, treatment plans, and medical records to optimize patient care and streamline...Local area
- ...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...Full timeTemporary workPart timeMonday to FridayFlexible hours
- ...Summary Performs admission and concurrent stay medical record review to determine appropriateness of admission, continued stay, and... ...discussing patient, work, or LMC‑related information with others. Utilizes the service recovery process to resolve complaints (GIFT)....Full timeTemporary workWork at officeFlexible hours
$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- Insight Global is looking for a Utilization Review Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for evaluating 3.5 patient care cases per hour (both inpatient and outpatient) and collaborating with doctors...Hourly payRemote 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...
$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- ...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...Permanent employmentWork experience placementLocal area
$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- ...contribute meaningfully. Note: New Jersey RN Active License is required. Role Description This is a Field work contract role for a Utilization Review Nurse. The Utilization Review Nurse will be responsible for performing utilization management, reviewing medical records,...Contract workRemote work