Get new jobs by email
- ...or bachelor’s Degree Licensure: Licensed RN or LPN is preferred Experience: Must have one (1) year experience in the Utilization Review process and/or two (2) years’ clinical experience in a psychiatric facility. Additional Skills: Highly proficient in Microsoft...SuggestedWork at officeLocal areaImmediate startFlexible hours
Perimeter Healthcare
Jackson, TN5 days ago $38.16 - $59.15 per hour
...determined by a candidate's expertise and years of experience, among other factors. Position Highlights: Position: RN Utilization Review Location: Naperville, IL Full Time: 40 hours/week Hours: Monday-Friday, 8:00a-4:30p, rotating every 6-8 weekend...SuggestedHourly payFull timePart timeFor contractorsMonday to Friday- Alliant Health Group is seeking a Pediatric Review Nurse to join their professional multi-disciplinary team in Atlanta, Georgia. This role involves conducting comprehensive medical reviews for Pediatric Programs, managing Medicaid member documentation, and performing clinical...Suggested
- A leading medical review organization is seeking Board‑Certified physicians in Pediatric Hematology Oncology for flexible, remote Utilization Reviews. This role requires conducting independent reviews of pediatric cases, engaging in peer-to-peer discussions, and ensuring...SuggestedRemote jobPart timeFlexible hours
$41.14 - $61.2 per hour
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. Pay...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
$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- ...remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift.The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in Utilization Management (UM), medical...SuggestedDaily paidLive inRemote workShift workDay shift
- OverviewTitle: Clinical Review Nurse - Prior Authorization ReviewLocation: Fully Remote (PST Time Zone - WA/OR Resident)Duration: 1... ...Clinical Review Nurse for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct concurrent and...SuggestedRemote work
- Job Description Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external...SuggestedFlexible hours
- We are seeking a DC licensed RN to perform utilization management reviews, ensuring healthcare services are medically necessary and meet quality standards. The role involves reviewing treatment plans, consulting with providers, documenting decisions, and supporting care...Suggested
$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- General Summary of Position Job Summary: MedStar Health is looking for a Utilization Review Technician to join our team at MedStar Harbor Hospital. The Utilization Review Technician will collaborate with and assist the multidisciplinary team to meet individualized patient...Suggested
- 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...SuggestedImmediate startRemote workDay shift
- ...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...
- 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...Permanent employmentFull timeWork at officeWork from home2 days per week
- ...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
$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...Contract workWork 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- 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
$18 - $19 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. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Accesses, triages...Work at officeLocal areaFlexible hours- Utilization Review Coordinator Job Details Job Location: Haltom City, TX 76117 Position Type: Full Time Job Shift: Any Job Category: Finance Description UR Coordinator Sierra Health and Wellness use evidence-based methods to accomplish the restoration of families, relationships...Full timeRemote workShift work
$81k - $110k
Avalon Health Care Management is now hiring a Case Manager of Utilization Management and Authorizations to join our team! Avalon Health... ...by managing authorizations, utilization management, concurrent review, and payor coordination while ensuring smooth transitions of care...Full timeContract workTemporary workImmediate start$78.56k - $110.91k
...Location: Remote Facility: Ascension Saint Thomas Department: Utilization Management Schedule: Part Time | Weekends Salary: $78,561.60... ...0 per year What You Will Do: Admissions & Medical Necessity Review: Evaluating service requests and admissions for medical...Temporary workPart timeLocal areaRemote workWeekend work- Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued - they're invaluable...Contract workLocal area
$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- 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
- ...expanding access to our unique model of care across the United States. Overview Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health...Work at office
- Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards. Requirements: Education/Experience: Graduate of an accredited...Work at office
