Get new jobs by email
- A leading medical review organization is seeking Board‑Certified physicians in Pediatric Hematology Oncology for flexible, remote Utilization Reviews. This role requires conducting independent reviews of pediatric cases, engaging in peer-to-peer discussions, and ensuring...SuggestedRemote jobPart timeFlexible hours
$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$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- ...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...SuggestedPermanent employmentWork experience placementLocal 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- ...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
- ...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
$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$73k - $75k
Utilization Review Nurse PRIMARY PURPOSE To provide timely, evidence-based utilization review services to maximize quality care and cost-effective outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment...SuggestedWork at officeFlexible hours- ...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
- ...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
- 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
- Job Description Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external...SuggestedFlexible hours
- 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...SuggestedFull timeReliefLocal areaMonday to Friday
$18.5 - $26.04 per hour
General Summary Responsible for supporting the utilization review system including data analysis, report writing, and program improvement. UR Specialist will develop and maintain a VOD Tracking and Receipt system. UR Specialist will maintain an expert level review of...SuggestedWork experience placement$18 - $19 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. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Accesses, triages...Work at officeLocal areaFlexible hours- Summary Of Position Assists the clinical staff with daily tasks, including ensuring the safety and welfare of all consumers, maintaining building safety and security, and providing general coverage and duties in support of the program's mission. Essential Responsibilities...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
- ...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...
- Description Responsible for providing utilization review and coordination of care throughout the healthcare continuum to promote quality and cost effective care to the members. Required Qualifications Nursing school graduate. California Registered Nurse License upon hire...Minimum wageWork at officeLocal areaShift work
- Responsibilities Utilization Review Coordinator PRN/Per Diem Weekend Shifts Via Linda Behavioral Hospital is a behavioral health provider serving Scottsdale and the greater Phoenix area. We opened in February 2022 and now offer a full continuum of inpatient and outpatient...Daily paidReliefWork at officeLocal areaShift workWeekend work
$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...Temporary workPart timeLocal areaRemote workWeekend work- ...members. We believe that our collective efforts will shape a healthier future for the communities we serve. How you’ll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to...Temporary workFlexible hours
$41.14 - $61.2 per hour
Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical guardian of healthcare efficiency and... ...resource utilization. Every day, you will meticulously review medical records, authorize services, and prepare cases for physician...- 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...Work at office
- Utilization Review Coordinator Job Details Job Location: Haltom City, TX 76117 Position Type: Full Time Job Shift: Any Job Category: Finance Description UR Coordinator Sierra Health and Wellness use evidence-based methods to accomplish the restoration of families, relationships...Full timeRemote workShift work
- Responsibilities Three Rivers Midlands is seeking a dynamic & talented Full-time Utilization Review Coordinator Three Rivers Midlands is a comprehensive behavioral health facility treating children and adolescents through residential and Rehabilitative Behavioral Health...Full timeLocal area
- WHAT WE'RE LOOKING FOR We have openings in our Omaha, Nebraska office for Utilization Review Nurses. The Utilization Review Nurse ensures all aspects of an injured worker’s treatment are effective, efficient, and in accordance with applicable legal requirements. This...Permanent employmentFull timeWork at officeWork from home2 days per week
- ...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,...
- ...vary based upon position type and/or level. Job Summary You will review patient cases for medical necessity and establish service... ...treatments, terminology, and clinical documentation Experience with utilization review, discharge planning, and levels of care determination...Work at officeImmediate start