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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
- ...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
$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- ...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,...SuggestedContract workRemote work
$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$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:...SuggestedFull timeTemporary workPart timeWork at officeRemote workShift 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
$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
$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- ...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...SuggestedTemporary workCurrently hiringFlexible hours
- ...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...Suggested
- ...Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. About the Role The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient...SuggestedFull timePart time
- 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...
- 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
$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...Hourly payWeekly payLocal areaShift work- 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...Work at officeLocal area
- ...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
- ...Miami-Dade and Broward counties.The following Job Description will also apply at Broward Pace Program sites. Job Summary The Utilization Review Analyst supports the Florida PACE Centers’ UM Program by combining administrative expertise with analytical skills to...Full timePart timeLocal areaShift work
- ...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
- ...that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff. Website: The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical...
$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$71.61k - $111k
Utilization Review Nurse - Albany Medical Center Overview Responsible for utilization management, quality screening, and delay management for assigned patients. Department/Unit Care Management/Social Work Work Shift Day (United States of America) Salary Range $71,6...Full timeShift work- 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
- 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
- ...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
- Overview Three Rivers Midlands is seeking a dynamic & talented Full-time Utilization Review Coordinator Three Rivers Midlands is a comprehensive behavioral health facility treating children and adolescents through residential and Rehabilitative Behavioral Health Services...Full timeLocal area
- ...Key Functions 1. Perform both internal and external record reviews as part of daily department operations. Cooperates with Admissions... ...outcome in certification record. Performs concurrent utilization review with insurance companies and relevant payers, documenting...Full timeWork at officeMonday to FridayShift work