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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...SuggestedHourly payFull timePart timeFor contractorsMonday to Friday- 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
- ...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, TN4 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...SuggestedWork at officeShift workWeekend work
$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...SuggestedShift 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
$73k - $75k
Utilization Review Nurse 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 who thrive in a collaborative environment...SuggestedWork at officeFlexible hours- Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial appeals where appropriate either during admission or post discharge. Providence caregivers are not simply valued - they’re invaluable. Join...SuggestedContract 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...SuggestedContract workWork at office- ...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...Suggested
- 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
- 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
- ...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,...SuggestedDaily paidContract workRemote workShift workWeekend work
$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$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...SuggestedHourly payWeekly payLocal areaShift work- 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...
- ...retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy,... ...in acute clinical care Experience with medical record review/utilization review/utilization management Additional Information Are you...Contract workPrivate practiceMonday to Friday
$25 - $28 per hour
Burkwood Treatment Center is seeking a Full Time Utilization Review Specialist and Aftercare Coordinator. Hourly Rate: $25.00 - $28.00 Purpose Statement Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Essential Functions...Hourly payFull timeWork at officeLocal area- Our Utilization Management Reviewers evaluate medical necessity for inpatient and outpatient services, ensuring treatment aligns with clinical guidelines, regulatory requirements, and patient needs. This role requires reviewing provider requests, gathering necessary medical...Remote workMonday to FridayFlexible hoursWeekend work
- 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 payRemote work
- ...plan of care for members based on authorization and concurrent review. Provides monthly telephonic outreach to ensure members needs are... ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards,...Contract workRemote workMonday to FridayFlexible hours
- ...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,...Private practiceImmediate start
$2,256.4 per month
Job Overview Our Client is currently seeking Utilization Review for positions in Washington, DC for a 5×8 Days shift. The ideal candidate will possess a current DC license or Compact license depending on the state. You must have a license and at least 1 year of recent...Shift workDay shift- Overview 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. Responsibilities Accesses, triages and assigns cases for utilization review (UR)....Work at officeLocal area
- ...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...Temporary workFlexible hours
- ...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
- 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
- ...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,...
- ...expanding access to our unique model of care across the United States. Overview Neuropsychiatric Hospitals is looking for a Utilization Review Nurse (RN) to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring health...Work at office
