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- ...or bachelor’s Degree Licensure: Licensed RN or LPN is preferred Experience: Must have one (1) year experience in the Utilization Review process and/or two (2) years’ clinical experience in a psychiatric facility. Additional Skills: Highly proficient in Microsoft...SuggestedWork at officeLocal areaImmediate startFlexible hours
Perimeter Healthcare
Jackson, TN6 days ago $38.16 - $59.15 per hour
...determined by a candidate's expertise and years of experience, among other factors. Position Highlights: Position: RN Utilization Review Location: Naperville, IL Full Time: 40 hours/week Hours: Monday-Friday, 8:00a-4:30p, rotating every 6-8 weekend...SuggestedHourly payFull timePart timeFor contractorsMonday to Friday- Alliant Health Group is seeking a Pediatric Review Nurse to join their professional multi-disciplinary team in Atlanta, Georgia. This role involves conducting comprehensive medical reviews for Pediatric Programs, managing Medicaid member documentation, and performing clinical...Suggested
- 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
- ...We are home to Nevada’s ONLY Level I Trauma Center, Designated Pediatric Trauma Center, Burn Care Center, and Transplant Center. We are... ...facility by ANCC, and we are on our journey to Magnet status. Review patient admissions for appropriateness, efficiency of resource...SuggestedWork at officeShift workWeekend 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- ...passionate about recovery and want to impact others in a meaningful way, we warmly invite you to join our growing family! Position Utilization Review Specialist to join our corporate NJ Team. The Utilization Review Specialist collaborates with Avenues Recovery facilities...SuggestedTemporary workFlexible hours
- Utilization Review Coordinator 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 services. Our modern 120-bed...SuggestedWork at officeLocal areaShift workWeekend work
- We are seeking a DC licensed RN to perform utilization management reviews, ensuring healthcare services are medically necessary and meet quality standards. The role involves reviewing treatment plans, consulting with providers, documenting decisions, and supporting care...Suggested
- RN-Utilization Review Nurse Inpatient Hybrid Must reside within the New York Tri-State Area - NY, NJ, or CT. VillageCare is looking for a self‑motivated and passionate RN as Utilization Review Nurse for a Full‑time position. This is an exciting and dynamic position...SuggestedFull time
- 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
- 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...SuggestedPermanent employmentFull timeWork at officeWork from home2 days per week
- 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
- ...levels of care from inpatient psychiatric and substance abuse detoxification, through SUD and mental health outpatient clinics. Utilization Review Specialist Job description Perform duties to authorize and review utilization of mental health and substance abuse services...SuggestedHourly payFull timeWork at officeVisa sponsorshipMonday to FridayWeekend work
- OverviewTitle: Clinical Review Nurse - Prior Authorization ReviewLocation: Fully Remote (PST Time Zone - WA/OR Resident)Duration: 1... ...Clinical Review Nurse for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct concurrent and...SuggestedRemote work
- ...remote role. You MUST live in the state of Washington (WA) to be considered. Care Manager RN, Per diem / On call, Day shift.The Utilization Review (UR) Nurse has a strong clinical background blended with knowledge and skills in Utilization Management (UM), medical...Daily paidLive inRemote workShift workDay shift
- ...compact)) Employment Type: 4-month contract with possibility of extension 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 workRemote workShift workWeekend work
$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...Contract workWork at office- ...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...
- 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
$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...Work experience placement- ...Miami-Dade and Broward counties.The following Job Description will also apply at Broward Pace Program sites. Job Summary The Utilization Review Analyst supports the Florida PACE Centers’ UM Program by combining administrative expertise with analytical skills to...Full timePart timeLocal areaShift work
$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
- 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
- ...through all levels of care in the substance abuse and mental health setting. Works with the UR Director and facility contacts on case reviews for pre-service, concurrent, and retrospective authorizations and appeals, looking for medical necessity and appropriateness of...Full timePart timeRemote work
- ...necessity and promote effective use of resources. Medical necessity reviews may include drugs and biologics, inpatient admissions,... ...Responsible for the effective and sufficient support of all Utilization Management activities to include review of inpatient and outpatient...Work at officeLocal areaFlexible hoursShift work
- Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards. Requirements: Education/Experience: Graduate of an accredited...Work at office
- Utilization Review Coordinator page is loaded## Utilization Review Coordinatorlocations: Telecommuter FLtime type: Full timeposted on: Posted Todayjob requisition id: R72621By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues...Work at officeLocal area
