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$26.46 - $33.07 per hour
A leading mental health facility in Reno, Nevada, is seeking an experienced Utilization Review Coordinator to manage clinical documentation and perform admission reviews. This role requires effective communication and a strong understanding of regulatory compliance in...SuggestedHourly pay$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 Review Nurse- Pool Under the supervision of the Manager of Utilization Management the Utilization Review RN conducts medical... ...experience required in the acute care setting preferably in pediatrics. Current knowledge of reimbursement requirements level of care...Suggested
- ...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
- ...range of behavioral health problems. As a part of our continued success and growth, we are seeking qualified applicants for a Utilization Review Manager. Position Description: The Utilization Manager is responsible for directing and overseeing the Utilization Program...SuggestedLocal area
- ...Director of Utilization Review Under the direction of the Director of Utilization Review, the Specialist will coordinate Medicaid Managed Care authorizations and re-authorizations for clients receiving behavioral healthcare services from Odyssey House's Part 820 residential...SuggestedTemporary workFlexible 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- ...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
- ...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
$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... ...throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care...SuggestedHourly payFull timeMonday to Friday- ...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
- ...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
$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- ...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....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
- ...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...
- ...Director Of Utilization Review Gulfport Behavioral Health System is an acute behavioral health hospital on the Mississippi Gulf Coast providing inpatient, partial hospitalization and outpatient services to children, adolescents, and adults. We have served our community...Local area
- ...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...Full timeRemote workShift work
- ...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...Work experience placementNight shift
- ...Description: Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Utilization Review Nurse (UR Nurse) , you’ll play an important role in helping us offer customized, self-funded insurance options to our clients...Full timeTemporary workWork at officeFlexible hours
Cobalt Benefits Group LLC
Exeter, NH4 days ago - ...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...Full timeTemporary workPart timeMonday to FridayFlexible hours
- ...Sycamore Springs Utilization Review Specialist At Sycamore 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...Full timeLocal area
$23.08 - $37.02 per hour
A leading pharmacy benefits manager is seeking an Initial Review Pharmacy Technician to play a key role in medical and pharmacy management. The ideal candidate will have 4 years of pharmacy experience, meet state licensure requirements, and possess strong communication...- Responsibilities Utilization Review Case Coordinator Opportunity: Full Time, Day Shift The Case Coordinator is responsible for managing and coordinating the treatment activities offered to the patient, interface with the treatment team/external case managers/managed...Full timeLocal areaShift workDay shift
- ...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
$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- ...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
- ...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
- Job Summary and Responsibilities As the Utilization Management (UM) Physician Reviewer, you will report to the Medical Director of UM and provide clinical expertise to ensure high‑quality, medically necessary, and efficient patient care aligned with regulatory requirements...Part timeLocal areaRemote workFlexible hours
- ...Utilization Management Nurse The Staff Pad is proud to partner with St. Peter's Health in Helena, Montana, in the search for a qualified... ...Management Nurse, you will support the Utilization Review RN Coordinator by overseeing and managing utilization functions...
