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$56.32 - $87.11 per hour
...Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial... ...orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network...SuggestedDaily paidMinimum wageFull timeContract workLocal areaShift work- ...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
- ...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
- ...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
- 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
$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 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
- ...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
$78.56k - $110.91k
...Location: Remote Facility: Ascension Saint Thomas Department: Utilization Management Schedule: Part Time | Weekends Salary: $78,561.60... ...0 per year What You Will Do: Admissions & Medical Necessity Review: Evaluating service requests and admissions for medical...SuggestedTemporary workPart timeLocal areaRemote workWeekend work$81k - $110k
Avalon Health Care Management is now hiring a Case Manager of Utilization Management and Authorizations to join our team! Avalon Health... ...by managing authorizations, utilization management, concurrent review, and payor coordination while ensuring smooth transitions of care...SuggestedFull timeContract workTemporary workImmediate start$17.44 per hour
About the Position Tulsa Center for Behavioral Health is recruiting for a Utilization Review Specialist. The role involves reviewing clinical documentation to ensure admission appropriateness, continued stay criteria, and special studies related to care delivery and treatment...SuggestedHourly payFull timeWork at officeFlexible hoursWeekend work$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$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- A leading healthcare provider is seeking a Full-time Utilization Review Coordinator in Columbia, South Carolina. This role involves precertifying and verifying benefits, coordinating caseload management, and collaborating with treatment teams. Candidates should have a...SuggestedFull time
- Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards. Requirements: Education/Experience: Graduate of an accredited...SuggestedWork at office
- ...employment)* Employer-paid Accident & Life Insurance (eligible after 60 days of employment)**Job Description:** The role of the Utilization Review Coordinator is to implement the organization’s Utilization Review (UR) process to ensure appropriate usage of available...Full timeRemote work
$35.62 - $52.99 per hour
Job Summary and Responsibilities As our Utilization Review LVN, your focus will be to provide high quality, cost-effective care which will enable patients to achieve maximum medical improvement while receiving care deemed medically necessary. The LVN assists in determining...Contract 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
- 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
- General Summary of Position Job Summary: MedStar Health is looking for a Utilization Review Technician to join our team at MedStar Harbor Hospital. The Utilization Review Technician will collaborate with and assist the multidisciplinary team to meet individualized patient...
$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
- ...regulatory timelines Collaborate with multidisciplinary teams Summary Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing clients' members with...Contract workRemote work
- Copper Springs East Job Title: Utilization Review Specialist Job Type: Full‑time Your experience matters At Copper Springs East, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact...Full timeTemporary workFlexible hoursShift work
- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration... ...Clinical Review Nurse for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct concurrent and...Contract workRemote work
- ...medical necessity and appropriateness of the treatment plan . This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from...Full timeContract workRemote work
- ...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
- ...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,...Private practiceImmediate start
- 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...Work at officeRemote workFlexible hours