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$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$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$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- Responsibilities Utilization Review (UR) Coordinator - Full‑Time Daytime position. Calvary Healing Center has served the Phoenix area and nationwide for over 60 years, specializing in addiction treatment for adults. The flagship Phoenix location offers detoxification...SuggestedFull timeLocal 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- ...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,...Suggested
- 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...SuggestedWork at officeLocal area
- ...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...Suggested
- 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...SuggestedHourly payRemote work
- Summary In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day shift, 7am- 3:30pm, Monday- Sunday every other week. Summary The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews...SuggestedDay shift
- ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately... ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,...SuggestedPrivate practiceImmediate start
- ...faxing discharge clinical information Accurately enter information into the UR spreadsheet Schedule and follow up on peer-to-peer reviews Assist the UR Manager with data reporting as directed Ensure all Medicare certification letters are signed by the appropriate provider...SuggestedPart timeWork at officeFlexible hours
- Overview Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote About Exact Billing Solutions Exact Billing Solutions is a unique team of medical billing professionals specializing in the substance use disorder, mental...SuggestedWork at officeRemote 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,...SuggestedContract workRemote workMonday to FridayFlexible hours
- 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
- ...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
- 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...Remote workMonday to FridayFlexible hoursWeekend work
$34.05 per hour
Job Details Job Location: Leesburg, FL 34748 Position Type: Full Time Salary Range: $34.05 Job Shift: Day Job Purpose The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that...Full timeTemporary workLocal areaFlexible hoursShift work- ...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
- ...admission through discharge. Serves as liaison to on-site external reviewers. Uses Midas for recording reviews and tracking denials. Adds... ...in applicable field of study required Six months psychiatric utilization review either for hospital or external review organization...Local 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:...Full 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...Permanent employmentWork experience placementLocal area
- 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
- 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...
- Job Title Job Description Avenues Recovery
$41 - $45.5 per hour
...supports members through clinical assessments, health education, and utilization management. Key Responsibilities: Perform clinical... ...outcomes. Conduct prospective, concurrent, and retrospective reviews for inpatient, rehab, referrals, and select outpatient services...Remote job- ...PATIENT CARE SECOND TO NONE! If you would like to be a part of our future team, please apply now! Position Summary The Psychiatric Utilization Review (UR) Coordinatoris responsible forconducting concurrent reviews for psychiatric patients to ensure medical necessity and...Full timeContract workTemporary workWork at officeImmediate startMonday to FridayShift work
$17.44 per hour
A state agency in Tulsa is seeking a Utilization Review Specialist I responsible for reviewing clinical documentation to ensure the appropriateness of admissions and ongoing care. The position requires a bachelor's degree or equivalent experience in social work or psychology...Hourly payFull time- A healthcare facility in Augusta, Georgia, is seeking a Utilization Review Coordinator to join their Case Management team. The role involves reviewing clinical data, collaborating with medical staff, and ensuring compliance with insurance authorization processes. Ideal...
$42.18 - $51.56 per hour
The Role Ready to help us transform healthcare? Bring your true colors to blue. 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...Hourly payFull timeWork at officeFlexible hoursShift work