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- ...New Mexico Oregon Utah Tennessee Texas Wyoming The Utilization Review Specialist assumes responsibility and accountability for admission... ...first, second and third level appeals. Consults with managers on problem cases and interfaces with case managers, clinical...SuggestedFull timeRemote work
Quorum Health
United States1 day ago - This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Case Manager - Utilization Review Specialist based in the United States. Join a healthcare team dedicated to improving utilization management...SuggestedFull timeLive inRemote work
- ...Jobgether, in partnership with a healthcare team, seeks a Case Manager – Utilization Review Specialist based in the United States. This fully remote role focuses on admission and concurrent reviews, denials prevention, and coordinated appeals to support patient care and...SuggestedRemote work
Jobgether
United States1 day ago $41.6k - $52k
...Job Title: Utilization Review Coordinator Reports To: Revenue Cycle Management Leadership Location: Remote FLSA Status: 90 day Temporary to Direct Hire Schedule: Monday-Friday 8am-5pm Compensation: $20-25/hour Northpoint Recovery Holdings, LLC began...SuggestedFull timeTemporary workRemote workMonday to Friday- ...Applications – Protection & Controls, Electric Utility is responsible for leading the... ...sales, application engineering, product management, business development, and market strategy... ...planning, CRM practices, and monthly business reviews. Evaluate and enhance sales...SuggestedFull timeRemote workFlexible hours
- ...Quorum Health Corporation is seeking a remote Utilization Review Specialist (Case Manager) to support admission decisions and appeals. The role requires an RN license and strong knowledge of criteria sets to support clinical appeals and quality reviews. Responsibilities...SuggestedFull timeRemote work
Quorum Health Corporation
Lexington, KY20 hours ago - ...To support the Utilization Review function, the part-time Utilization Review Coordinator will manage the authorization process by coordinating documentation, tracking authorizations, and assisting Utilization Review Specialists, all while working remotely. Key responsibilities...SuggestedPart timeRemote work
Virtual Vocations Inc
United States2 days ago - ...Responsibilities Full Time Utilization Review Coordinator - Needed! Springwoods Behavioral Health , an 80-bed behavioral health facility... ...and utilization as set forth in the UM plan by effective management and communication. The UM Coordinator functions as the internal...SuggestedFull timeLocal area
Arbour SeniorCare
Fayetteville, AR1 day ago - ...Responsibilities Utilization Review (UR) Coordinator Position: Full-Time Shift: Daytime For over 60 years, Calvary Healing Center... ...Coordinator Duties The UR Coordinator is responsible for managing the treatment activities offered to the patient, including...SuggestedFull timeLocal areaShift work
Clive Behavioral
Phoenix, AZ20 hours ago $34.82k - $55.99k
...The Utilization Review (UR) Intake Specialist provides staff support services including typing reports and correspondence, file handling and... ..., supporting the goals of the Utilization Review / Case Management department, and of CorVel. ESSENTIAL FUNCTIONS & RESPONSIBILITIES...SuggestedHourly payMinimum wageFull timeWork at officeLocal areaRemote workFlexible hours- ...Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in Illinois since 1989. Located in Champaign, Illinois, we provide a secure...SuggestedFull timeLocal area
Laurel Ridge Treatment Center
Champaign, IL1 day ago $20 - $30 per hour
...industry by delivering exceptional care, utilizing state-of-the-art facilities, and... ...Reports to: SeniorDirector of Revenue Cycle Management Department/Location: Remote FLSA Status:... ...Requirement: None Responsibilities Utilization Review on Behalf of the Clinics: Prescreen...SuggestedRemote workGuidelight Health
New York, NY20 hours ago- ...Patient Chart Reviewer In this position you will be reviewing patient charts to determine if pre-elective surgical cases should... ...3-5 years of clinical experience preferred. Previous utilization management or case management experience preferred. Certifications...SuggestedFull timeRemote workMonday to Friday
Henry Ford Health System
Troy, MI20 hours ago - ...Impact Advisors, LLC is a nationally recognized healthcare management consulting firm delivering Best in KLAS advisory, implementation... .... To learn more about us, visit Position Summary The Utilization Review (UR) / Utilization Management (UM) Lead is responsible for day...SuggestedFull time
- ...Northpoint Recovery is seeking an Utilization Review Coordinator to support the UR function remotely, coordinating administrative tasks and... ...with UR Specialists, Clinical Operations, and Revenue Cycle Management to ensure timely, accurate authorizations and effective payer...SuggestedRemote work
Northpoint Recovery
Meridian, ID20 hours ago - ...Recovery Unplugged is seeking an experienced Utilization Review Specialist to join our team. This remote, part-time role focuses on obtaining... ...maintaining insurance authorizations, communicating with managed care organizations, and collaborating with clinical teams....Part timeRemote workWeekend work
Recovery Unplugged
United States4 days ago - The Utilization Review Case Manager gathers demographic and clinical information on prospective, concurrent and retrospective in-patient admissions and out-patient treatment, certifies the medical necessity and assigns an appropriate length of stay while supporting the...Minimum wageFull timeWork at officeLocal areaRemote workFlexible hours
$90.9k - $129.9k
...patient interactions for this role, rather you will provide utilization review and quality assurance. Your role in our mission Review... ...providers. Enter prior authorization outcomes into the Medicaid Management Information System (MMIS) for processing. Participate in...Full timeWork experience placementRemote workHome officeFlexible hoursGainwell Technologies LLC
Columbus, OH4 days ago$18 - $20 per hour
...seeking a detail-oriented, compassionate professional to join our Utilization Review department. At Camber, we do not just talk about a... ...between our clinical treatment teams and health plans. You will manage initial, concurrent, and discharge interfaces to ensure children...Hourly payFull timeWork at officeRemote workKVC Shared Services
Olathe, KS20 hours ago- ...substance use disorder challenges. What You'll Do Responsible for managing all clinical authorization processes to ensure timely,... ...Behavioral Health or related field required preferred. 2-3 years of utilization review experience in behavioral health, addiction treatment, or...Daily paidFull timeRemote work
The Florida House
New York, NY20 hours ago $195k - $240k
...We are seeking a Director, Market Lead Utilities to join our Product team and own how InvoiceCloud... ...You’ll lead and grow a team of product managers, build prototypes hands-on, and spend... ...invests in to the investment review committee. Delivers the monthly review...Full timeSummer workLocal areaFlexible hoursShift work- ...Category): Sales, Marketing & Product Management Job Schedule: Full time Remote:... ...Position Description: Account Director, Utility The Account Director has overall responsibility... ...Provide regular reports, briefings and reviews as required using the agreed processes....Full timeLocal areaRemote workWorldwide
- ...Job Description VIVA HEALTH, ranked one of the nation's Best Places to Work by Modern Healthcare, is seeking a Case Manager, Utilization Review position to join our team in Birmingham, AL! VIVA HEALTH knows that nursing is not just a job; it is a calling. If you...Work from homeFlexible hoursNight shiftWeekend work
Triton Health Systems
Birmingham, AL17 days ago $30 - $45 per hour
...opportunity in Long Beach, CA. This role requires expertise in Medicaid and Medi-Cal operations, along with experience in Epic EHR and Utilization Review. The selected candidate will perform chart reviews, ensure documentation accuracy, and support Medicaid program metrics. This...Hourly payContract workRemote workPyramid Consulting
Long Beach, CA20 hours ago- ...Hansei Solutions is seeking an Utilization Review Specialist to act as the vital link between insurance payors and treatment facilities, advocating... ...with clinical staff to optimize authorization decisions, manage caseloads, and ensure accurate documentation while staying...Remote work
Hansei Solutions
Franklin, TN20 hours ago - ...Utilization Review (UR) Specialist Location: Open to candidates near Wyomissing PA & Chadds Ford PA (Hybrid / Remote Eligible) Job Type... ...Position Summary The Utilization Review Specialist manages the full lifecycle of authorizations and eligibility verification...Full timeRemote workMonday to FridayFlexible hours
Diversified Treatment Alternative Centers
Wyomissing, PA2 days ago - ...As Utilization Review Specialists, we are the liaisons between insurance payors and the treatment facilities we service, advocating for clients... ...client/facility and their respective insurance carrier. Manage caseloads through initial analysis, concurrent review, collaboration...Full timeWork at officeRemote work
Hansei Solutions
Franklin, TN5 days ago - ...Next step in progression could include Utilization Review Specialist IIATHENS ADMINISTRATORSExplore the Athens Administrators difference:... ...Workers' Compensation, Property & Casualty, Program Business, and Managed Care. Embrace a change and come make an impact with the...Full timeWork experience placementWork at officeImmediate startRemote workMonday to Friday
Athens Administrators
Orange, CA4 days ago $63.1k - $83.65k
...Position : Utilization Review Specialist Req.# : 26-144 FTE : Full-time, exempt Unit : UAW Department/Location : Utilization Management Compensation: $63,102.73-$83,647.81 The Final job offer is based on several factors (internal equity, skills, education...Full timeTemporary workRemote workMonday to FridayKent County CMH Authority
Grand Rapids, MI20 hours ago$63.1k - $83.65k
...making a difference by helping others. We are seeking a Utilization Review Specialist to perform utilization review of intellectual and... ...skills including word processing, spreadsheets, email, database management, and data entry skills. Ability to work in a fast-paced...Full timeTemporary workRemote workMonday to FridayKent County CMH Authority
Grand Rapids, MI20 hours ago
