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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$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- ...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
- ...coast. We are driven by a profound commitment to prioritize your well‑being so you can provide exceptional care to others. As a Utilization Review Specialist joining our team, you're embracing a vital mission dedicated to making communities healthier®. Join us on this...SuggestedFull timeTemporary workPart timeMonday to FridayFlexible hours
$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- 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
$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$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- ...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
- 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
$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$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...SuggestedFull 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...SuggestedContract workPrivate practiceMonday to Friday
- 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
- ...and healing environment that improves patient outcomes and empowers patients toward long-term recovery. Position Summary The Utilization Review Specialist is responsible for managing all aspects of insurance authorization and concurrent review for assigned patients....
- ...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,...Contract workRemote work
- 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
- 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
$75k - $95k
...Job Description Job Description Description: Utilization Review Manager Reports to: CEO Job Category: Salaried | Exempt | Full-Time Starting Salary: $75,000-$95,000/year (DOE) Job Site: Remote (must reside in Colorado) Job Summary: The Utilization...Hourly payFull timeRemote workNRT |Foundry Treatment Center
Steamboat Springs, CO9 days ago$27.73 - $54.06 per hour
...CST Job Summary Provides support for clinical member services review assessment processes. Responsible for verifying that services... ...multidisciplinary teams to promote the Molina care model. Adheres to utilization management (UM) policies and procedures. Required...Hourly payWork experience placementWork at office- A leading healthcare services provider seeks a Utilization Review Coordinator in Grand Rapids, Michigan. This role involves negotiating on behalf of patients and managing the review processes with insurance companies. Candidates should be RN, MA, or MSW qualified and have...
- Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for...Remote work
$23.08 - $37.02 per hour
A leading pharmacy benefit manager is seeking an Initial Review Pharmacy Technician in Austin, Texas. This role involves executing utilization management programs, reviewing patient information, and communicating with healthcare providers. The ideal candidate should have...$23.08 - $37.02 per hour
A pharmacy benefit manager is seeking an Initial Review Pharmacy Technician responsible for conducting clinical reviews and ensuring medication reimbursement. The successful candidate will have at least 4 years of pharmacy experience and be licensed as a pharmacy technician...$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- Position Summary The Supervisor of Utilization Review is a fully ON SITE opportunity at Northbrook Behavioral Health Hospital in Blackwood, NJ. This is not a remote position. The supervisor is responsible for overseeing the hospital’s utilization review process to ensure...
- ...evidence based clinical guidelines. Conducts prior authorization reviews to determine financial responsibility Qualifications 2 years... ...with Hospital Nursing (Med-Surg, ER) Well versed in Utilization Management-Must be able to determine elective vs urgent request...Private practice
- A leading healthcare provider in San Antonio seeks a Utilization Review Coordinator to conduct patient care evaluations and monitor treatment plans. This role involves collaborating with healthcare teams to ensure quality care and compliance with insurance requirements...
