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- 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
$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$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- ...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...SuggestedWork at officeImmediate start
- Job Title Job Description Avenues RecoverySuggested
- ...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
- ...Key Functions 1. Perform both internal and external record reviews as part of daily department operations. Cooperates with Admissions... ...outcome in certification record. Performs concurrent utilization review with insurance companies and relevant payers, documenting...SuggestedFull timeWork at officeMonday to FridayShift work
- ...Position Summary: Assists in the coordination of the appropriate utilization of services and resources of patient care and continuum at... ...: Assists in the coordination of all aspects of concurrent review process for individual cases. Coordinates clinical documentation...SuggestedPermanent employmentFull timeFor contractors
- ...Job Description Job Description POSITION POSTING: Utilization Review DEPARTMENTS: Nursing STATUS Part-Time: 24 hours per week HOURS : Day shift. Hours may be adjusted in response to workload demands; Low census may be utilized in accordance with hospital...SuggestedPart timeDay shift
- ...At Bradford Health Services, we don’t just invest in our patients—we invest in our people. About the Role: The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while managing...SuggestedFull timePart timeWeekend work
- ...successfully passing CHAP surveys and client audits; and operate with ethics at the center of our Core Values. We are looking for a Utilization Review Licensed Vocational Nurse to join our fast-growing team. Become part of a notable company and help us achieve our goals!...SuggestedWork at office
NEOGEN CARE
Los Angeles, CA24 days ago $60k - $72k
...Job Description Job Description Description: Utilization Review Manager Reports to: CEO Job Category: Salaried | Exempt | Full-Time Starting Salary: $60,000-$72,000/year (DOE) Job Site: Remote (must reside in Colorado) Job Summary: The Utilization...SuggestedHourly payFull timeRemote work- ...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...SuggestedFull timeTemporary workWork at officeFlexible hours
$40 - $63 per hour
...Job Description Job Description Salary: $40-$63 Utilization Review Nurse (RN) Las Vegas, NV | Full-Time Salary: $40 $63/hour Position Summary Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer...SuggestedFull timeWork at officeShift workWeekend work$17.44 per hour
...Job Description Job Description 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...SuggestedHourly payFull timeWork at officeFlexible hoursWeekend work- ...candidates to the culture of an organization as well as required skill sets 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
- ...Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscapeanalyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple...
- ...Utilization Review Specialist Collin Springs-Changes Plano is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care...Temporary workPart timeRelief
$41 per hour
...Medical Review Nurse (RN) Remote position, however, candidates must reside in the State of TX or State of IL This position is a contract for about 9 months. Pay: $41/hour RN working in the insurance or managed care industry using medically accepted criteria...Remote jobContract work$55k - $70k
...Job Description Job Description 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...Work at officeRemote workFlexible hours$65 per hour
...Job Description Job Description RN Case Manager / Utilization Review - Syracuse, NY (#25268) Location: Acute Care/Academic Medical... ...recertification prior to employment. Experience: Must have Pediatric experience. Minimum of 1.5 years of recent experience (...Hourly payFull timePrivate practiceMonday to FridayDay shift- ...Job Description Job Description A facility located near Lexington, Nebraska is seeking a Utilization Review Registered Nurse to join their team! Utilization Review Registered Nurse Opportunity: Full-time, permanent position Schedule: Monday-Friday,...Permanent employmentFull timeMonday to Friday
- ...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...Temporary workCurrently hiringFlexible hours
- ...safe, individualized discharge and providing proficient timely utilization management services to ensure that maximum reimbursement is... ...varied clinical settings. Two years experience in Utilization Review, Utilization Management or Case Management preferred. Applicant...Full timeLocal area
$211.2k - $277.2k
...Job Description Job Description Hi, we're Oscar. We're hiring a Physician Reviewer to join our Utilization Management team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members....Full timeLocal areaRemote workWork from homeHome officeWeekend work- Job Title This position is fully remote, however, you must reside in the State of Texas. The position is a contract for about six months. RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and...Remote jobContract work
- ...Job Description Job Description Summary: The primary responsibility of this role consists of reviewing member transportation requests that are over the contractual mileage guidelines. ESSENTIAL FUNCTIONS Reviewing and making approval/denial determinations for...Flexible hours
$103 per hour
...Senior Utilization Review Specialist The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack UMC. These include...Hourly payDaily paidFull timeContract workPart timeFor contractorsApprenticeshipWork experience placementShift workNight shiftWeekend workAfternoon shift- ...Job Description Job Description SUMMARY Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being responsible for coordinating phone calls, clinical requests...Work at office
$65 per hour
...Fully Remote Position Job Title : RN UTILIZATION REVIEW Location: Everett, WA 98201 Start Date: 05/04/2026 Duration: 13 weeks Schedule Shift: Day 5x8-Hour (08:00 - 16:30) Shift Notes: Days (5 8) | 08:00 16:30PAY DETAILS (72 HOURS / 2 WEEKS) Pay Rate...Local areaImmediate startRemote workMonday to FridayShift workWeekend work
