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- ...Utilization Review Nurse- Pool Under the supervision of the Manager of Utilization Management the Utilization Review RN conducts medical... ...experience required in the acute care setting preferably in pediatrics. Current knowledge of reimbursement requirements level of care...Suggested
$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- ...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
- 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
- ...Utilization Management Specialist Schedule/Shift: Monday - Friday 8:00a- 5:00p on site at our S Main Street Location. Key Functions 1. Perform both internal and external record reviews as part of daily department operations. Cooperates with Admissions to complete...SuggestedFull timeWork at officeMonday to FridayShift work
$32.48 - $38.98 per hour
...unique communities we serve. Summary This position facilitates utilization management processes to support the right care is provided at... ...patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care...SuggestedHourly payFull timeMonday to Friday- ...range of behavioral health problems. As a part of our continued success and growth, we are seeking qualified applicants for a Utilization Review Manager. Position Description: The Utilization Manager is responsible for directing and overseeing the Utilization Program...SuggestedLocal area
- ...for career advancement and more. Explore more details on the Benefits of Working at HHS webpage. Overview Functional Title: Utilization Review Nurse Job Title: Nurse II Agency: Health & Human Services Commission Department: UR Hospice Random Moment Study Posting Number...SuggestedFull timeTemporary workPart timeRemote workShift work
- ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately... ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,...SuggestedPrivate practiceImmediate start
- ...conversation can turn into a long-lasting and rewarding career! Job Description Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance...SuggestedPrivate practiceMonday to Friday
- ...online at: Via Linda Behavioral Health. Position Description The Utilization Management Coordinator reports to the Utilization Management... ...services. Interface with managed care organizations, external reviewers, and other payors for initial reviews, continued stay reviews...SuggestedDaily paidReliefWork at officeLocal areaShift workWeekend work
- Analyzes and evaluates current admission information and assigned patient population for supporting admissions and discharge planning. Responsibilities: Assesses clinical documentation based on current recognized criteria. Contacts third party payers to communicate clinical...Suggested
- ...Director Of Utilization Review Gulfport Behavioral Health System is an acute behavioral health hospital on the Mississippi Gulf Coast providing inpatient, partial hospitalization and outpatient services to children, adolescents, and adults. We have served our community...SuggestedLocal area
$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...SuggestedWork at officeFlexible hours- ...Manager of Utilization Review The Manager of Utilization Review oversees a team of utilization review nurses and coordinators, ensuring compliance with clinical regulatory standards, and enhancing the overall utilization review process to optimize patient care and...SuggestedWork experience placementNight shift
- ...Utilization Review Manager Forest View Hospital, located just seven miles southeast of downtown Grand Rapids, Michigan, is a private 108 bed psychiatric facility that serves children, adolescents and adults. We are licensed by the State of Michigan, fully accredited...Local area
- ...Utilization Review Coordinator Haltom City, TX 76117 Overview Position Type Full Time Job Shift Any Category Finance Description UR Coordinator Sierra Health and Wellness use evidence-based methods to accomplish the restoration of families, relationships...Full timeRemote workShift work
- ...Utilization Review Coordinator Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15 years. Located in Augusta, GA, our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse...
- ...Utilization Review Coordinator Fully Remote Franklin, TN 37067 Overview Level: Experienced Position Type: Full Time Education Level: 4 Year Degree Category: Health Care Description Who We Are: Join a passionate and caring team who work collaboratively...Full timeContract workLocal areaRemote workFlexible hours
- ...Utilization Management And Quality Screening Responsible for utilization management, quality screening and delay management for assigned... ...on departmental standards. While performing utilization review identifies areas for clinical documentation improvement and contacts...
- ...Utilization Review Nurse Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI...
$17.44 per hour
...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 the highest quality care to enhance the well-...Hourly payFull timeWork at officeFlexible hoursWeekend work$23.08 - $37.02 per hour
A leading pharmacy benefits manager in Tallahassee is seeking an Initial Review Pharmacy Technician. This role involves reviewing medication requests and making recommendations based on clinical criteria. The ideal candidate will have at least 4 years of pharmacy experience...$23.08 - $37.02 per hour
A healthcare solutions provider is looking for an 'Initial Review Pharmacy Technician' in Lincoln, Nebraska. This role involves evaluating medication reimbursement requests, maintaining clinical standards, and ensuring compliance with health regulations. Candidates should...Hourly pay$23.08 - $37.02 per hour
...leading healthcare provider in Little Rock, Arkansas, is seeking an Initial Review Pharmacy Technician. The role involves key responsibilities in medical and pharmacy management, focusing on utilization management and medication reimbursement. Candidates should have at...- ...Position Summary Assists in the coordination of the appropriate utilization of services and resources of patient care and continuum at... ...Accountabilities Assists in the coordination of all aspects of concurrent review process for individual cases. Coordinates clinical...Permanent employmentFull timeFor contractors
- ...within UHS and its 300+ Subsidiaries Shift differentials are paid for evening, night and weekend shifts Position Summary The Utilization Review Coordinator is dedicated to gather and coordinating information regarding patient symptomatology and treatment modalities for...Local areaShift workNight shiftWeekend workAfternoon shift
$33 - $37 per hour
...today to see how a conversation can turn into a long‑lasting and rewarding career! Job Description Are you an experienced RN Utilization Review Nurse looking for a new opportunity with a prestigious healthcare company as a RN Utilization Review Nurse. Do you want the...Private practiceWork at office- Job Overview Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers... ...and Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental...Price workExtra incomeFor contractorsRemote workFlexible hours
- A leading healthcare provider is searching for a Utilization Management Physician Reviewer. This remote part-time role demands clinical expertise to review prior authorizations and engage with healthcare professionals while ensuring compliance with regulations. Candidates...Part timeRemote workFlexible hours
