Average salary: $112,019 /yearly
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$50.84k
...Work hours prescribed and any additional hours deemed necessary for the responsibilities assigned. # Provide managed care and utilization review support for inpatient and outpatient adolescent or adult services. # Provide financial case management support in...SuggestedDaily paidWork at officeShift workDay shiftRosecrance Inc.
Rockford, IL10 days ago- Hybrid | Monday-Friday | 9:00 AM - 5:00 PM We are seeking an experienced Utilization Review Nurse to support inpatient and outpatient medical necessity reviews within a managed care environment. This role focuses on admission review, continued stay review, discharge planning...SuggestedMonday to Friday
- ...you’ll make an impact in this role Provide health care services regarding admissions, case management, discharge planning and utilization review. Review admissions and service requests within assigned unit for prospective, concurrent and retrospective medical necessity...SuggestedPart timeLocal areaRemote work
- ...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
- ...knowledge of local and national coverage determinations Recent work experience in a hospital or insurance company providing utilization review services Knowledge of Medicare, Medicaid, and Managed Care requirements Progressive knowledge of community resources, health...SuggestedPermanent employmentWork experience placementLocal area
- ...Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance RN Utilization Review PRIMARY PURPOSE To provide timely, evidence-based utilization review services to maximize quality care and cost-effective...SuggestedWork at officeLocal area
- Copper Springs East Job Title: Utilization Review Specialist Job Type: Full‑time Your experience matters At Copper Springs East, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact...SuggestedFull timeTemporary workFlexible hoursShift work
$55k - $70k
Utilization Review Specialist - Exact Billing Solutions (EBS) Lauderdale Lakes, FL - On-site - No Remote Salary $55K - $70K Who We Are Exact Billing Solutions is a unique team of revenue‑cycle management professionals specializing in the substance use disorder, mental...SuggestedWork at officeRemote workFlexible hours- 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
$95k - $105k
RN - Utilization Review Nurse Hybrid. Must reside within the New York Tri-State Area - NY, NJ, or CT. COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! Responsibilities VillageCare is looking for a self‑motivated and passionate RN as Utilization Review...SuggestedFull timeLocal areaWork from home- 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...SuggestedHourly payRemote work
$71.61k - $111k
Utilization Review Nurse - Albany Medical Center Overview Responsible for utilization management, quality screening, and delay management for assigned patients. Department/Unit Care Management/Social Work Work Shift Day (United States of America) Salary Range $71,6...SuggestedFull timeShift work- ...to the physician advisor, PA moonlighter, for a second level review as needed. Facilitates communication with service based multidisciplinary... ...3 years of acute care nursing experience is required; prior utilization management or case management experience is required. A...SuggestedTemporary workRemote workShift workWeekend work
- ...that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff. Website: The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical...Suggested
- ...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...SuggestedContract workRemote work
- ...Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Utilization Review Nurse Location(s): Los Angeles, CA Job Description: Ensuring appropriate, cost-effective, and high-quality care for New...Shift work
- Utilization Management RN | Contract-to-Hire Location: Remote (Must reside in PA, NJ, or DE for future conversion consideration) Licensure... ...including PA Department: Care Management & Utilization Review About the Role We’re hiring an experienced Utilization Review...Contract workRemote work
- ...including mental, physical, and financial wellness Professional development and growth opportunities How you’ll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine...Full timeTemporary workLocal areaFlexible hours
$24 - $56.17 per hour
A prominent healthcare provider based in New York is seeking a professional to provide support for clinical member services review processes. The role involves ensuring services are medically necessary and compliant with established guidelines. Candidates should possess...Hourly payWork at office- Overview Responsibilities Utilization Review (UR) Coordinator — Position: Full-Time — Shift: Daytime For over 60 years, Calvary Healing Center has provided a full continuum of care, specializing in addiction treatment for adults across the Phoenix area and Nationwide....Full timeLocal areaShift work
$34.05 per hour
Job Details Job Location: Leesburg, FL 34748 Position Type: Full Time Salary Range: $34.05 Job Shift: Day Job Purpose The Utilization Review Manager - RN at LIFESTREAM BEHAVIORAL CENTER is responsible for overseeing the utilization review process to ensure that...Full timeTemporary workLocal areaFlexible hoursShift work- Overview 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 Services...Full timeLocal area
- ...involvement. Role Description This is a part‑time role transitioning to a full‑time, on‑site role based in Wichita, KS, for a Utilization Review Nurse. The Utilization Review Nurse will be responsible for conducting utilization management reviews, creating discharge...Full timePart time
$90.77k - $149.74k
...outcomes. Our team of award‑winning nurses is growing, and we are looking for talented, compassionate RNs to join our team. The Utilization Review RN will: Identifies appropriate medical information necessary to certify and/or refer cases on admission and on continued...Full timeWork experience placementFlexible hoursShift work$108k
Job Description UW Medical Center has an outstanding opportunity for an experienced Utilization Review Nurse to join our team. WORK SCHEDULE Fully remote / work from home Must be available to work day shifts during Pacific Standard Time Sat, Sun and one day during...Full timeTemporary workWork experience placementWork at officeRemote workWork from homeShift workDay shift1 day per week- ...through all levels of care in the substance abuse and mental health setting. Works with the UR Director and facility contacts on case reviews for pre-service, concurrent, and retrospective authorizations and appeals, looking for medical necessity and appropriateness of...Full timePart timeRemote 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...Contract workRemote workFlexible hoursWeekend work- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving...Work at officeLocal area
- ...more per week. At Bradford Health Services, we don’t just invest in our patients—we invest in our people. About the Role The Utilization Review Coordinator plays a critical role in ensuring that patients at our facility receive the appropriate level of care while...Part time
$17.44 per hour
Agency 452 MENTAL HEALTH AND SUBSTANCE ABUSE SERV. Job Posting Title Utilization Review Specialist I Supervisory Organization Tulsa Center Behavioral Health Job Posting End Date Refer to the date listed at the top of this posting, if available. Continuous if date is...Hourly payFull timePart timeWork at officeFlexible hoursWeekend work
