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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$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
- ...expanding access to our unique model of care across the United States. NeuroPsychiatric Hospital of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring...SuggestedWork at office
$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$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- ...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
$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 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
- 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...Suggested
- ...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
- 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 is...SuggestedPermanent employmentFull timeWork at officeWork from home2 days per week
- Responsibilities 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...SuggestedFull timeLocal area
$39 - $41 per hour
Job Title: Utilization Review Nurse Location: United States Job Type: Contract Expected Hours per Week: 40 hours per week Schedule: Monday-Friday, 9:00 AM - 5:00 PM, Remote. Pay Range: $39-41 per hour We’re seeking an experienced Registered Nurse to support Utilization...SuggestedHourly payContract workWork at officeRemote workMonday to Friday$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$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...Shift work- ...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
- Overview Avalon Health Care Management is hiring a Case Manager of Utilization Management and Authorizations to join our team. This role... ...by managing authorizations, utilization management, concurrent review, and payor coordination while ensuring smooth transitions of...Full timeContract workTemporary work
- ...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,...
$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$57.28 - $88.92 per hour
Overview 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 years...Work at officeLocal areaShift 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...Permanent employmentWork experience placementLocal area
- ...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
- ...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...Work at officeLocal area
- Description Job Summary The UR Coordinator’s primary responsibility is managing, reviewing, and monitoring utilization of patient resources and obtaining payor authorization as required for all provided services. The UR Coordinator will function as liaison between payor...Temporary workWork at officeLocal area
- 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
- ...online at: Via Linda Behavioral Health. Position Description The Utilization Management Coordinator reports to the Utilization Management... ...services. Interface with managed care organizations, external reviewers, and other payors for initial reviews, continued stay reviews...Daily paidReliefWork at officeLocal areaShift workWeekend work
- A mental health service provider in Kirkland, WA is looking for a Utilization Review Coordinator. This role involves managing hospital resources and acting as a liaison between payers and treatment teams. The ideal candidate must have a Bachelor's degree in mental health...
- 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
- A leading healthcare provider in Houston is looking for a Case Management Director who will oversee staff selection, develop team dynamics, and ensure regulatory compliance. Candidates should possess a Bachelor's degree in Nursing and five years of healthcare management...