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- 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
$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- ...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
$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- ...successfully passing CHAP surveys and client audits; and operate with ethics at the center of our Core Values. We are looking for a Utilization Review Licensed Vocational Nurse to join our fast-growing team. Become part of a notable company and help us achieve our goals!...SuggestedWork at office
NEOGEN CARE
Los Angeles, CA3 days ago $55k - $70k
Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue‑cycle management professionals specializing in the substance use disorder, mental...SuggestedWork at officeRemote workFlexible hours- ...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...SuggestedWork at officeLocal area
- 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...Suggested
$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$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...SuggestedFull timeWork experience placementMonday to Friday$81k - $110k
Avalon Health Care Management is now hiring a Case Manager of Utilization Management and Authorizations. $81,000 - $110,000 / yr This... ...by managing authorizations, utilization management, concurrent review, and payor coordination while ensuring smooth transitions of care...SuggestedContract workTemporary workImmediate start- Fusion HCR is hiring! Direct Hire - Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. Overview Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care...Suggested
- 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...SuggestedDaily paidReliefWork at officeLocal areaShift workWeekend 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- ...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...
$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...Remote workShift work- 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
- 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...
- ...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
$52.26 - $81.13 per hour
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 maintaining...Hourly payFull timeLocal areaShift workDay shift- ...Director of Utilization Review Under the direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations for clients receiving behavioral healthcare services from Odyssey House's Part 820 residential...Temporary workFlexible 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
- Overview Utilization Management Dept. PRN Any PRN Lexington Health is a comprehensive network of care that includes six community medical... ...Summary Performs admission and concurrent stay medical record review to determine appropriateness of admission, continued stay, and...Full timeTemporary workReliefWork at officeFlexible 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...Contract workWork at office- 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
- ...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
- ...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
$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
