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$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$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- ...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
- ...Clinica Review Nurse Travel offering nursing profession RN specialty utilization review. Regular pay rate $63. Shifts per week 5. Scheduled hours 40. Start date 04/10/2026. End date 07/10/2026. Duration 13 weeks. City Uniondale, State NY, Zip Code 11556. RC HealthcareSuggestedShift work
- ...care services in alignment with the physician’s treatment plan. Utilizes strong clinical skills to assess, plan, implement, coordinate,... .... Ensures case management program objectives are met by reviewing the effectiveness of alternative care services while maintaining...SuggestedContract workImmediate startRemote work
- ...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
- ...Utilization Review Specialist Avenues Recovery Center is a nationwide network of drug and alcohol rehab centers with eighteen locations across seven states. We offer highly individualized treatment in a clean, modern, comfortable setting, spanning every level of care...SuggestedTemporary workCurrently hiringFlexible hours
$35 - $40 per hour
Base Pay Range $35.00/hr - $40.00/hr Location Fully Remote Position Summary The Utilization Review Nurse serves as a key liaison in coordinating resources and services to meet patients’ needs, ensuring efficient, cost-effective, and compliant delivery of home health...SuggestedContract workRemote workFlexible hoursWeekend work- ...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,...Suggested
$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$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- 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
- 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
- ...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...SuggestedFull timeRemote work
$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- ...expanding access to our unique model of care across the United States. NeuroPsychiatric Hospital of Indianapolis is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring...Work at office
- 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...Full timeReliefLocal areaMonday to Friday
$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 and...Hourly payLocal areaShift work$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...Hourly payFull timeWork at officeFlexible hoursWeekend work- ...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
$71.61k - $111k
...Range: $71,612.39 - $110,999.20 Responsibilities Responsible for Utilization Management, Quality Screening and Delay Management for... ...based on Departmental standards. While performing utilization review identifies areas for clinical documentation improvement and contacts...Shift work- ...appropriateness of the treatment plan in the context of insurance or managed care. Qualifications Required: RN with IL Active License, with Utilization experience; familiar with MCG and ASAM criteria. Preferred: Inpatient hospital experience or ER background. Seniority level Mid-...Contract work
$73k - $75k
...Place to Work® Fortune Best Workplaces in Financial Services & Insurance 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...Work at officeFlexible hours$76k - $85k
...challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing a medical management software system on a day-to-day...For contractorsH1bWork at officeLocal areaRemote work$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:...Full timeTemporary workPart timeWork at officeRemote workShift 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...Permanent employmentWork experience placementLocal area
- ...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
- ...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
- ...unrestricted Massachusetts RN license. Compact licensure is not required. Overview: We are seeking an experienced Inpatient RN Utilization Reviewer to independently manage a clinically complex inpatient caseload across multiple care settings, including acute, subacute,...Daily paidContract workShift workWeekend work
- A healthcare provider is seeking a Utilization Review Coordinator in Tennessee to ensure the safety and security of youth under care. The role involves managing patient care, performing clinical reviews, and ensuring adherence to reimbursement processes. Candidates should...Flexible hours