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  • $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... 
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    Endeavor Health

    Naperville, IL
    3 days ago
  • 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... 
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    Remote job
    Part time
    Flexible hours

    Medical Review Institute of America

    Dallas, TX
    3 days ago
  • $41.14 - $61.2 per hour

    Job Summary and Responsibilities As our Utilization Management Professional, you will be a critical...  .... Every day, you will meticulously review medical records, authorize services, and...  ...emergency centers offering adult and pediatric care for the Greater Houston area. Pay... 
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    CommonSpirit Health

    Houston, TX
    3 days ago
  •  ...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... 
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    University Medical Center of Southern Nevada (UMC)

    Las Vegas, NV
    4 days ago
  • $71.61k - $111k

    Utilization Review Nurse page is loaded## Utilization Review Nurselocations: 43 New Scotland Avenue Albany, NY 12208time type: Full timeposted...  ...to the region’s largest hospital, only Level 1 adult and pediatric trauma centers, and only children’s hospital. The downtown campus... 
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    Albany Medical College

    Albany, NY
    5 days ago
  • $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... 
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    Akkodis

    California, MO
    2 days ago
  • 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... 
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    SPECTRAFORCE

    Washington DC
    4 days ago
  •  ...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... 
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    Providence Swedish Medical Center

    Seattle, WA
    4 days ago
  •  ...success. Job Description • Responsible for conducting timely reviews of all requests for services required to meet medical necessity...  ...providers against plan review criteria and benefit guidelines • Utilizes clinical information to determine if criteria for medical necessity... 
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    Integrated Resources Inc.

    North Charleston, SC
    2 days ago
  • 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... 
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    Daily paid
    Relief
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    Universal Hospital Services Inc.

    Scottsdale, AZ
    3 days ago
  • Currently seeking a Utilization Management RN . Please see details and qualifications below: Position is remote - candidate must reside...  ...evaluate members’ clinical conditions through medical record review to determine medical necessity for services. Using advanced clinical... 
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    Immediate start
    Remote work
    Day shift

    The Judge Group

    New York, NY
    2 days ago
  •  ...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,... 
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    US Tech Solutions

    Oklahoma City, OK
    4 days ago
  • $65 per hour

     ...coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while maintaining high-quality patient...  ...care planning and discharge planning. Conduct utilization review to ensure appropriate level of care and services. Collaborate... 
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    Pride Health

    New York, NY
    5 days ago
  • General Summary of Position Job Summary: MedStar Health is looking for a Utilization Review Technician to join our team at MedStar Harbor Hospital. The Utilization Review Technician will collaborate with and assist the multidisciplinary team to meet individualized patient... 
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    MedStar Health

    Baltimore, MD
    5 days ago
  • $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... 
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    IntePros

    Phoenix, AZ
    5 days ago
  • About the job Utilization Review Specialist Join Our Team: As a Utilization Review Specialist, you will play a pivotal role in managing and performing various processes related to medical records requests, retrospective review requests, and chart appeals. If you are organized... 

    Staffosaurus

    Boynton Beach, FL
    5 days ago
  • What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving... 
    Work at office
    Local area

    Briteliferecovery

    Englewood Cliffs, NJ
    5 days ago
  • 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... 

    NRI, Inc.

    Washington DC
    4 days ago
  • $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 office
    Flexible hours

    Hispanic Alliance for Career Enhancement

    Florida, NY
    4 days ago
  • $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... 
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    Pacific Staffing

    Sacramento, CA
    4 days ago
  • 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 pay
    Remote work

    Insight Global

    Raleigh, NC
    5 days ago
  • $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... 
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    Flexible hours

    Sedgwick

    Nashville, TN
    5 days ago
  •  ...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... 

    Universal Hospital Services Inc.

    New York, NY
    5 days ago
  • 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 employment
    Full time
    Work at office
    Work from home
    2 days per week

    Berkshire Hathaway Homestate Companies

    Omaha, NE
    5 days ago
  •  ...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... 
    Hourly pay
    Full time
    Work at office
    Visa sponsorship
    Monday to Friday
    Weekend work

    Evolve Treatment Centers

    Southlake, TX
    5 days ago
  • $55k - $70k

    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 in the substance use disorder, mental... 
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    Remote work
    Flexible hours

    Exact Billing Solutions

    Florida, NY
    5 days ago
  • 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... 
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    Remote work
    Flexible hours

    Exact Billing Solutions

    Florida, NY
    1 day ago
  •  ...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... 
    Temporary work
    Currently hiring
    Flexible hours

    AVENUES RECOVERY CENTER

    Jackson, NJ
    2 days ago
  • $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

    Sheppard Pratt

    Towson, MD
    2 days ago
  • 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

    Providence Health Plan Group

    California, MO
    3 days ago