Average salary: $112,292 /yearly
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- Responsibilities Three Rivers Midlands is seeking a dynamic & talented Full-time Utilization Review Coordinator Three Rivers Midlands is a comprehensive behavioral health facility treating children and adolescents through residential and Rehabilitative Behavioral Health...SuggestedFull timeLocal area
- Summary In Utilization Management at Main Campus Lee Building Work schedule will be 7on / 7off on the Day shift, 7am- 3:30pm, Monday- Sunday every other week. Summary The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews...SuggestedDay shift
$76k - $85k
...challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing a medical management software system on a day-to-day...SuggestedFor contractorsH1bWork at officeLocal areaRemote work$38.5k
About the Position Under general direction of the Director of Operations, the Utilization Review (UR) Specialist helps to manage the facility’s utilization management processes. This includes preparing documentation necessary for the pre-certification of admissions and...SuggestedHourly payFull timeWork at officeMonday to FridayFlexible hoursShift work- Utilization Review Pharmacist Shape the drug benefit landscape—analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple payers. Conduct retrospective...Suggested
$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- ...admission through discharge. Serves as liaison to on-site external reviewers. Uses Midas for recording reviews and tracking denials. Adds... ...in applicable field of study required Six months psychiatric utilization review either for hospital or external review organization...SuggestedLocal areaFlexible hours
$55 per hour
...message the job poster from Akkodis Akkodis is hiring a Concurrent Review Nurse to support our client in the Healthcare space. Location:... ...or clinic setting. Preferred: Experience in case management, utilization management, or discharge planning. Experience working in a...SuggestedFull timeContract workTemporary workLocal areaRemote 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,...SuggestedContract workRemote workMonday to FridayFlexible hours
- Responsibilities Utilization Review (UR) Coordinator - Full‑Time Daytime position. Calvary Healing Center has served the Phoenix area and nationwide for over 60 years, specializing in addiction treatment for adults. The flagship Phoenix location offers detoxification...SuggestedFull timeLocal 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- 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
- Responsibilities Three Rivers Midlands is seeking a dynamic & talented Full‑time Utilization Review Coordinator. Three Rivers Midlands is a comprehensive behavioral health facility treating children and adolescents through residential and Rehabilitative Behavioral Health...SuggestedFull timeLocal area
- ...Burn Care Center, and Transplant Center. We are a Pathway Designated facility by ANCC, and we are on our journey to Magnet status. Review patient admissions for appropriateness, efficiency of resource utilisation and compliance with third‑party payer requirements....SuggestedWork at officeShift 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...SuggestedRemote work
- Overview As our Utilization Review Nurse, you will coordinate and perform all aspects of Worker\'s Compensation, auto, and general liability claims for medical management activity (IME/Peer Review, UR) to ensure optimum medical care service delivery, utilization of resources...Temporary workWork at officeFlexible hours
$23.08 - $37.02 per hour
A progressive pharmacy benefit manager is hiring an Initial Review Pharmacy Technician in Hartford, Connecticut. This role is vital for executing utilization management programs, reviewing requests for appropriateness, and providing top-tier customer service. Candidates...- ...experienced individual for a position involving advanced clinical and regulatory consultation. Responsibilities include conducting utilization reviews, collaborating with the healthcare team, and advising on treatment plans. Candidates must have a Bachelor's degree in Nursing...
- 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...
$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...- ...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...
- This position requires prior UM experience. Major Responsibilities Documents utilization review activity per department and medical center standards in a timely manner. Performs and documents accurate and timely concurrent and retrospective reviews based on approved...Work at office
$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$45.9 - $71.4 per hour
Utilization Review RN - Remote Providence Health Plan caregivers are not simply valued - they’re invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual...Remote jobLocal area- 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...
- 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
- ...Utilization Review Assistant The Utilization Review Assistant ensures the timely and accurate collection of data and documents necessary for the utilization review process as well as independent medical review. This is a hybrid opportunity, requiring initial onsite...Work at officeImmediate startWork from home2 days per week3 days per week
$2,221 - $2,374 per week
Join to apply for the Registered Nurse Concurrent Utilization Review role at Tucson Medical Center 1 day ago Be among the first 25 applicants Join to apply for the Registered Nurse Concurrent Utilization Review role at Tucson Medical Center Get AI-powered advice on this...Full timePart time$27.02 - $48.55 per hour
...workplace flexibility. Position Purpose Performs a clinical review and assesses care related to mental health and substance abuse... ...planning Analyzes BH member data to improve quality and appropriate utilization of services Provides education to providers, members and...Hourly payFull timeContract workPart timeWork at officeRemote workFlexible hours$90.87 - $154.33 per hour
A healthcare management company is seeking a remote Physician Clinical Reviewer specializing in cardiology. This role involves reviewing medical service requests, providing clinical rationale for appeals, and ensuring compliance with medical guidelines. Candidates must...Remote job