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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- 40 hours per week Position: Utilization Review (UR) Nurse Company Overview Telenett is a leading healthcare company based in Honolulu, HI. We provide innovative and high-quality healthcare services to our clients, including insurance companies, hospitals, and healthcare...SuggestedRelocation package
- 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...SuggestedWork at office
- Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical...SuggestedRemote workMonday to FridayFlexible hoursWeekend work
- ...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
- ...through all levels of care in the substance abuse and mental health setting. Works with the UR Director and facility contacts on case reviews for pre-service, concurrent, and retrospective authorizations and appeals, looking for medical necessity and appropriateness of...SuggestedFull timePart timeRemote work
$71.61k - $111k
...Range: $71,612.39 - $110,999.20 Responsibilities Responsible for Utilization Management, Quality Screening and Delay Management for... ...based on Departmental standards. While performing utilization review identifies areas for clinical documentation improvement and contacts...SuggestedShift 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- 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...SuggestedLocal area
$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- ...Utilization Review Manager We are currently seeking a Utilization Review Manager to join our Transitional Care Team. This is a full-time management role and will be required to work onsite. The purpose of this position is to manage the design, development, implementation...SuggestedFull timeWork at office
- ...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 Director joining our team, you're embracing a vital mission dedicated to making communities healthier. Join us on this...SuggestedFull timeTemporary workPart timeWork at office
- ...seeking a change from the hospital setting? Position Summary The Pediatric Review Nurse, as a member of a professional multi-disciplinary team... ...by Alliant Health Solutions in the Medical Management and Utilization Review Contract (MMURS). The Pediatric Review Nurse reviews...SuggestedContract work
$30 - $34 per hour
Overview Utilization Review Nurse - Remote at Astrana Health Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Compensation: $30.00 - $34.00 / hour Department: HS - UM This is a fully remote position. Description Astrana Health is looking for an experienced...Remote jobHourly payMonday to Friday- ...Monday - Friday from 8am-4:30pm. Requirements 2 years of RN experience performing care for hospitalized patients 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity Must live within one hour of the BJC Commons (4249 Clayton...Full timeReliefLocal areaRemote workWork from homeMonday to FridayFlexible hoursShift work
- Responsibilities Three Rivers Midlands is seeking a dynamic & talented Full-time Lead Utilization Review Coordinator. Three Rivers Midlands is a comprehensive behavioral health facility treating children and adolescents through residential and Rehabilitative Behavioral...Full timeLocal area
$55.56 - $85.96 per hour
A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and collaborating with healthcare teams...Hourly pay- Utilization Review (UR) Coordinator page is loaded## Utilization Review (UR) Coordinatorlocations: Solero Behavioral Transitions - Columbustime type: Full timeposted on: Posted 9 Days Agojob requisition id: R-0000115298**Job Address:**10270 Blacklick - Eastern Road NWPickerington...Flexible hours
$42.18 - $51.56 per hour
## **The Role**The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and medical necessity of outpatient rehabilitation and other services within scope of practice per business needs. The reviewer will ensure services align...Work at officeFlexible hoursShift work$72.23 - $99.98 per hour
...RN Case Manager assists patients in the utilization of appropriate health care services.... ...required to know and understand will be reviewed and evaluated during job specific/department... ...s services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-...Daily paidMinimum wageLocal areaShift work- ...Manager Centralized Utilization Review At Houston Methodist, the Manager Centralized Utilization Review (UR) position is responsible for leading the daily operations of the Utilization Review department to ensure efficient, high-quality, and compliant utilization management...Permanent employment
- A leading healthcare solutions provider is seeking a Clinical Care Reviewer to evaluate medical necessity for inpatient and outpatient services. This role involves reviewing provider requests, making determinations based on clinical guidelines, and collaborating with healthcare...Remote job
$90.87 - $154.33 per hour
A leading pharmacy benefit manager is seeking a Physician Clinical Reviewer specializing in Dermatology for a remote role. Key responsibilities include reviewing clinical cases, collaborating with physicians for determinations and ensuring compliance with medical guidelines...Remote job- ...agency in San Antonio is seeking a Nurse II to join their Medicaid CHIP Services team. The successful candidate will handle utilization reviews and ensure proper service delivery in various programs for individuals with intellectual and developmental disabilities. This...Remote jobFull time
$30.37 - $59.21 per hour
...DESCRIPTION This role provides support for clinical member services review assessment processes. Responsible for verifying that services... ...teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required Qualifications...Hourly payWork experience placementWork at officeRemote workShift workWeekend work$62.7k - $100.4k
A healthcare organization is seeking a Clinical Care Reviewer II responsible for processing medical necessity reviews and assisting with care coordination activities. Candidates need to hold an Associate's degree in nursing and have at least three years of clinical experience...- ...Employee Assistance Program that is available 24/7 to provide support Employee Appreciation Days Responsibilities A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and the interdisciplinary team, provides leadership and advocacy...Part time
$90.87 - $154.33 per hour
A healthcare management company is seeking a remote Physician Clinical Reviewer specializing in Dermatology. This role involves reviewing cases that require clinical expertise, interacting with physicians, and providing clinical rationale for appeals. Candidates must hold...Remote job