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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
...Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future... ...has three community emergency centers offering adult and pediatric care for the Greater Houston area. Depending on the position...SuggestedFull time- ...Utilization Management Specialist Schedule/Shift: Monday - Friday 8:00a- 5:00p on site at our S Main Street Location. Key Functions 1. Perform both internal and external record reviews as part of daily department operations. Cooperates with Admissions to complete...SuggestedFull timeWork at officeMonday to FridayShift work
- Complexity of Work: Essential Competencies and Skills: Excellent customer service and interpersonal skills. Able to effectively present information, both formal and informal. Strong written and verbal communications skills with all levels of internal and external customers...SuggestedWork experience placement
$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$44.16 - $77.58 per hour
...patients in an acute care environment. Accountabilities include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation of interventions, regulatory compliance and patient advocacy. The goal of the...SuggestedMinimum wageFull timeRelocation packageShift workDay shift1 day per week$32.48 - $38.98 per hour
...unique communities we serve. Summary This position facilitates utilization management processes to support the right care is provided at... ...patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care...SuggestedHourly payFull timeMonday to Friday- ...facilities from coast to coast. From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to...SuggestedFull timeLocal area
$24 - $56.17 per hour
A prominent healthcare provider based in New York is seeking a professional to provide support for clinical member services review processes. The role involves ensuring services are medically necessary and compliant with established guidelines. Candidates should possess...SuggestedHourly payWork at office$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- ...specializes in examining medical records and developing concise and pertinent clinical reviews to support authorization obtainment, avoid payment denial, and optimize reimbursement. The Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization...SuggestedWork at officeHome officeShift workWeekend work
- ...conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance...SuggestedPrivate practiceMonday to Friday
- ...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
- ...Manager of Utilization Review The Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical regulatory standards, and enhancing the overall utilization review process to optimize patient care and...SuggestedWork experience placementNight shift
- ...Utilization Review Coordinator Haltom City, TX 76117 Overview Position Type Full Time Job Shift Any Category Finance Description UR Coordinator Sierra Health and Wellness use evidence-based methods to accomplish the restoration of families, relationships...SuggestedFull timeRemote workShift 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-...Hourly payFull timeWork at officeFlexible hoursWeekend work- ...Utilization Management And Quality Screening Responsible for utilization management, quality screening and delay management for assigned... ...on departmental standards. While performing utilization review identifies areas for clinical documentation improvement and contacts...
$40.72 - $63.12 per hour
...Job Description Job Description Job Title: Utilization Review Nurse (RN) Location: Las Vegas, Nevada Job Type: Full-Time Salary: $40.72 – $63.12 per hour Position Summary: We are seeking an experienced Utilization Review Nurse (RN) to join a healthcare...Hourly payFull timeWork at officeShift workWeekend work- ...s nursing professionalism, teamwork, and superiority in patient care. Position Summary Reviews patient admissions for appropriateness, efficiency of resource utilization and compliance with third party payer requirements. Duties include analyzing medical charts,...Work at officeShift workWeekend work
- ...persistently represent a disproportionate amount of unnecessary utilization and cost, regardless of whether they are engaged with other... ...together as one inclusive group Description: The Utilization Review Nurse ensures appropriate utilization of health services by...Temporary workMonday to Friday
- ...Utilization Review Coordinator Fully Remote Franklin, TN 37067 Overview Level: Experienced Position Type: Full Time Education Level: 4 Year Degree Category: Health Care Description Who We Are: Join a passionate and caring team who work collaboratively...Full timeContract workLocal areaRemote workFlexible hours
- ...Utilization Review Coordinator Position Type: Full Time Job Shift: Day Education Level: High School Travel Percentage: Negligible Category: Admin - Clerical Description Job Summary: Under the administrative supervision of the Director of Utilization...Full timeShift work
- ...Utilization Review Specialist At Cottonwood Springs, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those...Temporary workFlexible hours
- ...Position Summary Assists in the coordination of the appropriate utilization of services and resources of patient care and continuum at... ...Accountabilities Assists in the coordination of all aspects of concurrent review process for individual cases. Coordinates clinical...Permanent employmentFull timeFor contractors
$23.08 - $37.02 per hour
A healthcare solutions provider is looking for an 'Initial Review Pharmacy Technician' in Lincoln, Nebraska. This role involves evaluating medication reimbursement requests, maintaining clinical standards, and ensuring compliance with health regulations. Candidates should...Hourly pay- ...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...Full timeReliefLocal areaRemote workWork from homeMonday to FridayFlexible hoursShift work
- A leading pharmacy benefits manager in Santa Fe seeks an Initial Review Pharmacy Technician to play a key role in medication review and reimbursement. You will manage clinical criteria for medication approvals, communicate with healthcare providers, and conduct program...
- ...Blue Cross. Residency in or relocation to Louisiana is preferred for all positions. Position Purpose The Behavioral Health Utilization Reviewer is responsible for conducting clinical reviews of behavioral health service requests, claims, and appeals to confirm medical...Work at officeLocal areaRelocation
- A leading healthcare provider in Houston is looking for a Utilization Management Coordinator to provide administrative case management and participate in various performance improvement plans. The ideal candidate should have at least one year of experience in case management...
$23.08 - $37.02 per hour
A leading pharmacy benefits manager is seeking an Initial Review Pharmacy Technician in Cheyenne, Wyoming. In this role, you will play... ...crucial role in medical and pharmacy management by executing utilization management programs, reviewing requests for therapeutic...Hourly pay
