Average salary: $116,921 /yearly
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$60.63 - $92.46 per hour
...Utilization Management Case Manager Santa Barbara, CA, United States Job Info This is a RT/Trauma Utilization Management Case Manager Minimum: 2 years direct patient care experience in an acute care setting. Other patient care experience may be considered....SuggestedHourly payWork experience placement- ...Utilization Management Position At MercyOne, health care is more than just a doctor's visit or a place to go when you need medical attention... ...employers. General Requirements: Responsible for the review of inpatient and outpatient admission records for appropriate...SuggestedFull timeFor contractorsWork at officeFlexible hoursShift workDay shift
- ...position is also responsible for preparing weekly, monthly, quarterly and year-end reports. Responsibilities: 1. Conducts on-site reviews at participating provider offices to assess environment, quality of physicians medical records, and compliance with documentation...SuggestedRemote work
Winston Medical Staffing
Newark, NJ12 days ago $37.32 - $55.99 per hour
Case Management Assistant We are so glad you are interested in joining Sutter Health! Organization: CPMC-California Pacific Med Center Position Overview: Responsible in assisting in the overall case management of designated patients in a particular program. Planning...SuggestedFull timeMonday to FridayShift workWeekend work- ...Utilization Review RN Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit...Suggested
- ...Utilization Review RN The Utilization Review RN reviews client health records to ensure proper utilization of treatment resources. Responsibilities And Duties: Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case...SuggestedWork at officeShift workWeekend work
- ..., treatment, and length of stay in hospital to comply with government and insurance company reimbursement policies. Performs utilization review and management, including quality review, case review for third party payers’ requirements. Ensures optimal reimbursement from...SuggestedWork at office
$35 - $45 per hour
Base pay range $35.00/hr - $45.00/hr Direct message the job poster from IntePros IntePros is seeking a Remote Utilization Review Nurse serves as a key clinical liaison, coordinating resources and services to meet patients’ needs while ensuring compliance with federal...SuggestedContract workRemote workWeekend work- Description JOB PURPOSE: The Care Integration Utilization Review Coordinator will be responsible for gathering, reviewing and tracking all documents associated with clinical documentation requests. Maintains information regarding these requests and coordinates responses...Suggested
- Description The Utilization Review Specialist coordinates insurance authorizations for individual therapy and IOP services, ensuring clients receive appropriate and timely care. This role works closely with clinical staff, psychiatry, and payors to gather documentation...SuggestedCasual workLocal areaAfternoon shift
- ...lives of our patients, families, and communities every day. Overview Medical Behavioral Hospital of Clear Lake is looking for a Utilization Review Coordinator to coordinate patients’ services across the continuum of care by promoting effective utilization, monitoring...SuggestedWork at office
$51.43 - $79.84 per hour
Description Utilization Review RN @ Swedish Medical Center Part time 0.7 FTE Evening Shift Fantastic benefits and compensation package offered by Providence that begin on your first day of employment. Join us, and find out how many ways we offer you the chance to focus...SuggestedPart timeWork at officeLocal areaShift workAfternoon shift- ...preferred work hours are 8:30 am / 9 am - 5 pm / 5:30 pm central time zone.Responsible for performing Workers’ Compensation utilization review, which includes prospective, concurrent, expedited, and retrospective reviews to determine medical necessity and appropriateness...SuggestedLong distance
- Role Summary: Perform pre-service utilization reviews of medical records and treatment plans to determine whether requested services are medically necessary, appropriate, and efficient. Key Duties Review clinical documentation and proposed care plans for medical necessity...Suggested
- Job Desciption The Utilization Review Specialist (URS) exercises independent judgment and professional discretion in the practice of case management to a select group of patients. The URS collaborates with physicians to ensure that patients are at the appropriate level...SuggestedShift work
- The Utilization Review RN is responsible for working with insurance companies and managed care systems for the authorization, concurrent and retrospective review of inpatient admissions and services. This position will obtain authorization for each admitted patient. Review...Full time
- Role Summary Reviews medical records and treatment plans to determine medical necessity, appropriateness, and efficiency of requested... ...for medical necessity, appropriateness, and cost-effective utilization. Collaborate with physicians, members, caregivers, and care teams...
- Position Summary The Utilization Review (UR) Specialist is responsible for obtaining and maintaining insurance authorizations for clients receiving substance use disorder treatment services. This position works closely with clinical staff, admissions, and insurance companies...Work at office
$51.8k - $102.8k
...about this position, we encourage you to apply - even if your experience doesn’t match every requirement. About the role The Utilization Review Nurse is responsible for reviewing and processing medical services requests for members of Quantum Health’s employer groups...Work at office- The Registered Nurse, Utilization Review is a U.S.-licensed clinician who performs utilization management and review for a Michigan health plan client under our client's domestic onshore service offering. Working within the client's systems and evidence-based clinical...Work from home
- ...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
$20 - $25 per hour
...back, and treating every individual with empathy and respect. POSITION SUMMARY: As a key member of the Northpoint team, he Utilization Review Coordinator supports Northpoint’s Utilization Review (UR) function by coordinating the administrative and operational components...Full timeTemporary workFor contractorsRemote workMonday to Friday$20 - $30 per hour
...the behavioral health industry by delivering exceptional care, utilizing state-of-the-art facilities, and prioritizing the well-being of... ...Exempt Travel Requirement: None Responsibilities Utilization Review on Behalf of the Clinics: Prescreen referrals to project/...Remote work- The Utilization Review Support Specialist is responsible for assuring insurance coverage of clients for treatment, by obtaining pre-certification and authorizations for various levels of care from insurance companies (the payers). The pre-certification and authorizations...Work at office
- Mountain View Hospital is looking for a Utilization Review Coordinator to join our team!JOB SUMMARY: As a member of the Utilization Management Team, the URCoordinator helps establish and maintain efficient methods of ensuring the medical necessity and appropriateness of...Full timePart timeRelief
$18 - $20 per hour
...where your contributions are truly valued? Camber Connect is seeking a detail-oriented, compassionate professional to join our Utilization Review department. At Camber, we do not just talk about a supportive culture—we live it. We are proud to share that our team has...Hourly payFull timeWork at officeRemote work- ...Utilization Review Nurse- Utilization Management Location: METROHEALTH MEDICAL CENTER Biweekly Hours: 80.00 Shift: 7a-330p The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-...Shift work
$63.1k - $94.65k
...certifications, and overall qualifications. *Must have current compact RN license, or be willing to obtain* Schedule Information Our Utilization Review team provides coverage seven days a week, operating between 8:00 a.m. and 10:00 p.m. To support our patients and partners,...Work at officeFlexible hoursShift work- Overview Vantage Point Behavioral Health Hospital is seeking a Full Time Utilization Review Specialist at our Fayetteville, AR location. PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Act as liaison...Full timeWork at officeLocal area
- ...Dental, vision, life, accident insurance, and telehealth options for those working 20 hours or more per week. About the Role The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient...Full timePart time
