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$84.96k - $127.89k
...Manager of Utilization Review and Case Management Professional Development Nursing -- Care Management Patchogue, NY ID: 1162703_RR00121106 Full-Time/Regular NYU Langone HospitalSuffolk is a 306-bed medical center, providing care to residents of eastern Long Island...SuggestedFull time- Responsibilities Utilization Review Manager (URM) 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. Calvary’s proven...SuggestedFull timeLocal areaShift work
$70k - $80k
...Utilization Review Coordinator Guidelight Health is a cutting-edge behavioral healthcare company dedicated to transforming lives through... ...Review Coordinator Reports to: Director of Revenue Cycle Management Department/Location: Remote, but only considering candidates...SuggestedFull timePart timeRemote workGuidelight Health
United States1 day ago- ...Job Title: Utilization Review Case Manager Status: Full-Time, Non-Exempt, Hourly Schedule: 8:00am-4:30pm PST Join AMFM Healthcare as a Utilization Review Case Manager! The Utilization Review (UR) Case Manager serves as a key member of the interdisciplinary...SuggestedHourly payFull timeWork at officeLocal areaImmediate startFlexible hours
A Better Life Recovery LLC
San Juan Capistrano, CA3 days ago - ...Job Title Utilization Management Nurse Job Description The Corporate UM and Denials team is responsible for: medical necessity reviews, admission status determinations, ongoing payer communication, clinical documentation support, concurrent utilization review...SuggestedWork at officeRemote work
$18 - $20 per hour
...Utilization Review Coordinator Primary Purpose: To assign utilization review requests; to verify and enter data in appropriate system(s... ...Enters demographics and UR information into claims or clinical management system; maintains data integrity. Obtains all necessary...SuggestedWork at officeLocal areaRemote workFlexible hoursSedgwick
United States3 days ago$77.96k - $120.37k
...The Case Management Supervisor is responsible for directing the operations of their designated... ...May perform daily, weekly, monthly reviews of various reports, invoices, logs and expenses... ...technical aptitude with the ability to utilize Microsoft Office including Excel...SuggestedMinimum wageFull timeWork at officeLocal areaRemote workFlexible hoursNight shiftCorVel
Folsom, CA4 days ago- ...To support clinical staff in a collaborative environment, the full-time Utilization Review Coordinator will manage utilization review requests, verify and enter data into systems, and respond to inquiries while working remotely. Key responsibilities Access, triage, and...SuggestedFull timeWork at officeRemote work
Virtual Vocations Inc
United States1 day ago - ...In this position you will be reviewing patient charts to determine if pre-elective surgical cases should be boarded as inpatient... ...Minimum 3-5 years of clinical experience preferred. Previous utilization management or case management experience preferred. CERTIFICATIONS/...SuggestedFull timeRemote workMonday to FridayShift work
Henry Ford Health System
United States13 hours ago $50k - $80k
...supporting treatment programs through insurance authorization, utilization review, and payer communication. The team works closely with... ...who is organized, communicates clearly, and is comfortable managing a caseload where timelines directly affect patient care. A hybrid...SuggestedFull timeWork at officeRemote workAtlantic Health Strategies
Boca Raton, FL1 day ago- ...leading healthcare company in Washington, D.C. is seeking a Medical Director to oversee inpatient medical necessity reviews and utilization management. This role requires strong analytical and communication skills, as well as 5+ years of clinical experience post-residency...SuggestedRemote work
Humana
Washington DC1 day ago - ...is seeking an experienced Medical Director to conduct clinical reviews and guide decision-making in inpatient care. The role... ...of clinical experience, with a focus on hospital medicine and utilization review. Join a distinguished team to impact patient outcomes while...SuggestedRemote work
Humana
Columbus, OH2 days ago - ...Medical Director, Utilization Management The Medical Management team ensures that Blue Shield is on the cutting edge of medical, medication, and... .... In this role you will deliver and collaborate on clinical review activities, which includes management of the physician...SuggestedFull timePart timeWork at officeLocal areaWork from homeHome office2 days per week
Blue Shield Of California
San Diego, CA1 day ago - ...Center in South Kansas City, MO is seeking a Supervisor of Behavioral Health Utilization Review to join our team. This role facilitates and directs the Utilization Review Department, Case Management and Reception teams of a 24/7 inpatient residential and hospital program...SuggestedFull timeRemote workMonday to FridayDay shift
Saint Luke's
Kansas City, MO4 days ago - ...a Medical Director to conduct inpatient medical necessity reviews while collaborating with healthcare providers. This role requires... ...include performing clinical reviews, providing utilization management determinations, and ensuring compliance with regulatory requirements...SuggestedRemote workMonday to Friday
Humana, Inc.
Nashville, TN1 day ago $236.5k
...Chief Medical Director by directing medical management and quality improvement initiatives. The role emphasizes leadership in utilization management, ensuring compliance with... ...a dedicated team, you'll conduct medical reviews, collaborate with clinical staff, and actively...Remote job- ...be a perfect fit for you! Position Summary: As the Utilization Review Coordinator, you will develop and implement systems for authorizations... ...or problems to appropriate staff/departments. Payer Management Obtain and maintain authorization for each patient....Local areaRemote work
Meadows of Wickenburg Inc
United States4 days ago - ...Director Of Utilization Review The Director of Utilization Review is responsible for the strategic leadership, operational execution, and... .... The position also advances technology-enabled utilization management, interoperability, and population health strategies in...Full timeRemote workFlexible hours
Cobalt Benefits Group
United States1 day ago - ...lifestyle with both professional and personal fulfillment. Position Overview The primary role of the Case Manager is to review and monitor members’ utilization of health care services with the goal of maintaining high quality, cost-effective care. This role will provide...Summer workLocal area
- ...necessary and efficient healthcare services, the full-time Utilization Review Specialist will evaluate patient records and treatment plans... ...At least 2 years of experience in utilization review, case management, or clinical healthcare roles Strong knowledge of medical terminology...Full timeRemote work
Virtual Vocations Inc
United States1 day ago $184.8k - $277.2k
...growth and ecosystem expansion within the Utilities vertical, including power generation,... ...predictive maintenance, safety, resiliency, DER management, and sustainability.Translate utility... ...Qualcomm has to offer - and you can review more details about our US benefits at this...Work experience placementWork at officeWork from home$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...Work at officeRemote workFlexible hoursICBD Holdings
Florida, NY1 day ago- ...highest‑level resource specialist in public utilities and lead a multidisciplinary team working... ...formulation activities. Provide technical review and feedback on staff written work products. Coordinate with the Branch Manager, Executive Leadership, and Commissioner leadership...Work at officeRemote work
- ...Spectrum Billing Solutions offers industry-leading revenue cycle management services for healthcare providers. Our team has deep... ...efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will...Work at officeRemote workFlexible hours
Spectrum Billing Solutions
Skokie, IL1 day ago - A leading healthcare provider in Chicago is hiring a Clinical Care Manager to oversee high-quality, patient-centered care through Utilization Review. The role requires an active RN license in Illinois and significant experience in healthcare settings. Responsibilities include...Remote job
- ...Working remotely in a full-time capacity, the Behavioral Health Utilization Review Specialist will manage the authorization of treatment through insurance and managed care companies, performing pre-certification, concurrent, and appeal reviews while ensuring compliance...Full timeRemote work
Virtual Vocations Inc
United States13 hours 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, CA2 days ago$87.14k - $114.66k
...SWCA Environmental Consultants seeks a qualified Lead Project Manager - Utility Permitting with strong interpersonal skills and experience... .... Application deadline: Our team will begin reviewing applications immediately, and interviews will be scheduled with...Full timeWork at officeLocal areaImmediate startSWCA Environmental Consultants
Lombard, IL4 days ago- ...performed, within the State of Arizona. PURPOSE OF THE JOB The Utilization Review Supervisor coordinates the activities of the UR department... ...QUALIFICATIONS Preferred Work Experience 1 year of managed care/health plan experience 1 year of Medicaid and Medicare...Full timeWork experience placementRemote work2 days per week1 day per week
- ...mission-driven environment where employees can grow while making a meaningful difference every day. Job Summary The Utilization Review department manages all aspects of a patient’s stay related to initial authorization, concurrent reviews and discharge coordination with...Full timeWork at officeRemote workMonday to Friday
KVC Health Systems
Wichita, KS2 days ago
