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$56.32 - $87.11 per hour
...Description Oversee utilization management and review of patients care delivery while in the hospital and provide clinical reviews and denial... ...orthopedics, women's services, emergency and trauma care, pediatrics and neonatal intensive care. Our not-for-profit network...SuggestedDaily paidMinimum wageFull timeContract workLocal areaShift 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- ...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
- ...successfully passing CHAP surveys and client audits; and operate with ethics at the center of our Core Values. We are looking for a Utilization Review Licensed Vocational Nurse to join our fast-growing team. Become part of a notable company and help us achieve our goals!...SuggestedWork at office
- ...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,...SuggestedContract workRemote workMonday to FridayFlexible hours
$78.56k - $110.91k
...Location: Remote Facility: Ascension Saint Thomas Department: Utilization Management Schedule: Part Time | Weekends Salary: $78,561.60... ...0 per year What You Will Do: Admissions & Medical Necessity Review: Evaluating service requests and admissions for medical...SuggestedTemporary workPart timeLocal areaRemote workWeekend work- ...providing evidence‑based outpatient and inpatient psychiatric treatment programs with successful outcomes. Position Summary: The Utilization Review Coordinator performs all functions related to the use of hospital resources and reimbursement. Utilization Review functions...SuggestedWork at officeLocal area
- 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...SuggestedFull timeReliefLocal areaMonday to Friday
$38.67 - $58.05 per hour
Job Requirements This role is full-time. Monday - Friday 8:00 am - 4:30 pm EST. Responsible for performing utilization management. Proactively review, identify and document potentially avoidable utilization and patient quality/efficiency concerns. Work collaboratively...SuggestedFull timeWork experience placementMonday to Friday$73k - $75k
...career with us, experience our caring culture, and enjoy work-life balance. 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...SuggestedWork at officeFlexible 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$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- Overview Title: Clinical Review Nurse - Prior Authorization Review Location: Fully Remote (PST Time Zone - WA/OR Resident) Duration... ...Clinical Review Nurse for Prior Authorization Review to join our Utilization Management team. In this role, you will conduct concurrent and...SuggestedContract workRemote work
- ...responsible for a wide range of administrative responsibilities including obtaining authorization for all levels of care, medical necessity review, monitoring of patients benefits and is knowledgeable of SJMC contractual agreements. The UR specialist works closely with numerous...Suggested
$71.61k - $111k
...America) Salary Range: $71,612.39 - $110,999.20 Responsibilities Utilization management and quality screening for assigned patients. Delay... ...proper use of MCG and documentation requirements through case review and inter‑rater reliability studies. Collaborate with the...SuggestedRemote workShift work- ...Anderson Cancer Center; and the Tilman J. Fertitta Family College of Medicine at the University of Houston. Job Summary The Utilization Management Review Nurse (UMRN) performs technical and administrative work required to evaluate the necessity, appropriateness, and...Work experience placementWork at officeRemote workFlexible hoursWeekend work
- A healthcare provider in Florida seeks a Utilization Review Coordinator to monitor patient treatment activities and collaborate with healthcare teams for optimal care. This full-time position requires a Registered Nurse, LPN, or Master's level Social Worker with experience...Full time
$57.28 - $88.92 per hour
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. Upon hire: California Registered Nurse License...Minimum wageWork at officeLocal areaShift work- A leading healthcare provider in San Antonio seeks a Utilization Review Coordinator to conduct patient care evaluations and monitor treatment plans. This role involves collaborating with healthcare teams to ensure quality care and compliance with insurance requirements...
- Primary Residence must be in the state of California (Remote within CA ONLY) Supervisor of Utilization Review Registered Nurse (Remote) This is a full-time, permanent role with a growing case management company. The nurse will have more autonomy with their caseload while...Permanent employmentFull timeRemote workHome office
- A leading pharmacy benefit manager is seeking an Initial Review Pharmacy Technician in Des Moines, Iowa. The role involves critical tasks in medical and pharmacy management, such as reviewing requests for medication appropriateness and providing clinical consultation to...
- Position Summary The Supervisor of Utilization Review is a fully ON SITE opportunity at Northbrook Behavioral Health Hospital in Blackwood, NJ. This is not a remote position. The supervisor is responsible for overseeing the hospital’s utilization review process to ensure...
- ...culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary The Social Worker-Utilization Review monitors adherence to the hospital's utilization review plan to ensure appropriate use of hospital services, admissions, and...
$41 - $45.5 per hour
...supports members through clinical assessments, health education, and utilization management. Key Responsibilities: Perform clinical... ...outcomes. Conduct prospective, concurrent, and retrospective reviews for inpatient, rehab, referrals, and select outpatient services...Remote job$55.56 - $85.96 per hour
A healthcare facility in California is seeking a Utilization Review Case Manager to validate patient admissions and levels of care. The role involves performing patient chart reviews, securing authorizations for clinical services, and collaborating with healthcare teams...Hourly pay- A leading healthcare provider in Jacksonville is seeking a TEMP FT Utilization Review Coordinator to monitor treatment activities and ensure quality patient care. The ideal candidate will have a nursing or social work background with experience in Utilization Management...Temporary workWeekend work
- Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for...Remote work
- 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...Work experience placement
- A healthcare management firm is seeking a Physician Reviewer to join their remote team. The role involves performing real-time case reviews... .... The position offers flexibility and requires knowledge in utilization management and experience with Medicare and Medicaid. #J-18808...Remote job
$30.37 - $59.21 per hour
...least 2 years of experience in hospital acute care or managed care, excellent organizational skills, and strong communication abilities. This role also requires commitment to weekend shifts and adherence to utilization management protocols. #J-18808-Ljbffr Molina HealthcareRemote jobHourly payShift workWeekend work
