Average salary: $228,787 /yearly
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$275k - $300k
...5,000-$300,000) Full benefits: health, vision, dental, vacation, CME, PTO Requires 5+ years experience in Medicare Advantage Utilization Review/Utilization Management and an active unrestricted CA license ASAPstart date Sacramento is the state's capital andhas over 450...SuggestedPermanent employmentFull timeRemote workWork from homeMonday to FridayIntegrity Healthcare
Sacramento, CA2 days ago- ...Ongoing Daily schedule: Remote, flexible full-time schedule Practice setting: Telehealth / Utilization Management Types of procedures: Comprehensive review of medical records; synthesis of complex clinical scenarios; determinations based on national guidelines...SuggestedWeekly payFull timeLocumLocal areaImmediate startRemote workFlexible hoursShift work
All Medical Personnel , LLC
Atlanta, GA2 days ago $110k - $120k
...including Prior Authorization Lead Nurses and Review Nurses. The goal of the Clinical... ...cooperation and support to the other PANs, physician reviewers, Supervisor(s)/Managers(s),... ...further evaluation for their quality or utilization implications and bring these items to the...SuggestedFull timeCasual workImmediate startRelocation packageFlexible hoursRegal Medical Group
Canoga Park, CA2 days ago$75.12 per hour
...Overview The Per Diem Advanced Practice Nurse (APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating competencies in leadership, direct clinical practice, consultation/collaboration...SuggestedHourly payDaily paidFull timePart timeApprenticeshipWork experience placementWork at officeShift workNight shiftWeekend workAfternoon shiftHackensack Meridian Health
Hackensack, NJ2 days ago- ...The Per Diem Advanced Practice Nurse (APN) or Physician Assistant (PA) for the Transition Utilzation Review Team utilizes a patient-centered coordinated care model, demonstrating competencies in leadership, direct clinical practice, consultation/collaboration, coaching...SuggestedDaily paid
HACKENSACK UNIVERSITY MED CNTR
Hackensack, NJ2 days ago - ...Utilization Review Surgery Nurse - RN Pascagoula Hospital | Full-Time | Monday-Friday rotating weekends/Holidays | 2809 Denny Ave Pascagoula, Mississippi United States Position Overview: The Case Manager focuses on clinical quality and resource...SuggestedFull timeWork at officeMonday to FridayShift workDay shift
Singing River Health System
Pascagoula, MS4 days ago $269.5k - $425.5k
...quality, effectiveness and coordination of the medical review services. Additionally, performs Utilization Management reviews and directs/coordinates aspects... ...and services and may serve as a liaison between physicians, and other medical service providers in selected situations...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote workWeekend workUnitedHealth Group
Phoenix, AZ21 hours ago- ...Great Place to Work" since 2015. Position Summary The Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of authorization requests, organizational determinations/ disputes, and auditing/training of...SuggestedWork at officeRemote work
Martins Point Health Care
Portland, ME2 days ago - ...The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. Responsible for obtaining and tracking approvals, denials, and additional information requests received from...SuggestedPart timeRemote workShift work
Henry Ford Health System
Troy, MI3 days ago - ...more than 30 locations and more than 860 physicians and advanced care practitioners offering... ...the activities of Case Management and Utilization Management to facilitate the collaborative... ...and discharge planning. Performs timely review and delivery of necessary clinical...SuggestedPart timeWork at officeFlexible hoursShift workWeekend work
Williamson Health
Franklin, TN5 hours agonew $118.46k - $177.31k
...UTILIZATION REVIEW NURSE SUPERVISOR II Print ( Apply UTILIZATION REVIEW NURSE SUPERVISOR II Salary $118,457.04 - $177,314.... ...Medicine and Sciences (CDU), DHS hospitals are training sites for physicians completing their Graduate Medical Education in nearly every...SuggestedFull timeWork experience placementWork at officeShift workNight shiftAfternoon shiftThe County of Los Angeles
Los Angeles, CA21 hours ago- ...Position Purpose: Works in partnership with physicians, nurse case managers, and other... ...appropriateness for the corresponding level of care utilizing evidence-based criteria.... ...Discharge Planning, and Case Management. Reviews the appropriateness of Severity Index/Intensity...SuggestedContract workWork experience placementFlexible hours
DOCTORS HEALTHCARE PLANS, INC.
Miami, FL2 days ago - Join Optum/UnitedHealth Group to support behavioral health and substance abuse case management through utilization reviews and care coordination. While not a member facing role, you'll help ensure they receive the right level of care at the right time. This is a fully remote...SuggestedRemote workMonday to Friday
Optum
Phoenix, AZ5 days ago $38 - $40 per hour
...Job Title : Retro Claims Reviewer Location : West Hills/Canoga Park 91305 Compensation : LVN $38-$40 hourly RN $45-$50... ...Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare...SuggestedHourly payContract workTemporary workTEKsystems
Canoga Park, CA10 hours ago$70.97 - $125 per hour
...sector. Job Description Acentra seeks a Psychiatrist Physician Reviewer (PRN) to join our growing team. Job Summary: The Psychiatrist... ...to operations relating to the peer review process, utilization review activities, and other activities requiring clinical...SuggestedHourly payReliefLocal areaRemote workCNSI
Lombard, IL21 hours ago- ...RN Utilization Specialist - Utilization Review Casual Days At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive... ...issues. Makes appropriate referrals to internal physician advisors and contracted third party review company per...For contractorsCasual workWork at officeLocal areaRelocation package
Northwestern Medicine Central DuPage Hospital
Palos Heights, IL1 day ago $52.47 - $83.95 per hour
...Summary of Essential Duties: The Utilization Management (UM) Registered Nurse - Medicare... ...supports post-discharge clinical reviews for Medicare Short Stay cases and assists... ...timelines. The UM RN collaborates with physicians, revenue integrity, and payer partners...Shift workCedars-Sinai
Los Angeles, CA4 days ago- ...Registered Nurse Case Manager, Utilization Review, Chart Abstractor PRN The RN Case Manager is responsible for comprehensive coordination... ...role in the multidisciplinary team to achieve patient and physician satisfaction and optimal outcomes. Must be able to work with...Temporary workReliefFlexible hoursWeekend work
USPI, INC.
Oklahoma City, OK23 hours ago $2,500 - $3,000 per week
...Job Title: Registered Nurse (RN) – Case Manager (Utilization Review) Location: Santa Clara, CA - 95051 Duration: 3 Months+ (Possibility of... ...medical necessity and payer requirements. · Collaborate with physicians, interdisciplinary teams, and insurance providers for care coordination...Local areaShift workDay shiftCareers Integrated Resources Inc
Santa Clara, CA14 hours ago- ...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
Berkshire Hathaway Homestate Companies
Omaha, NE2 days ago $110k - $120k
...A healthcare management firm is seeking a Utilization Manager to ensure appropriate and efficient medical care. The ideal candidate will... ...an active California Nursing License. Responsibilities include reviewing utilization, supporting discharge planning, and interfacing...PriMed Management Consulting Services , Inc.
Stockton, CA5 days ago- ...A facility in Englewood, CO is seeking its next amazing Social Worker to work in Case Management (Utilization Review). Nurses and allied healthcare professionals are in high demand nationwide, and our team of industry-leading, traveler-favorite recruiters can get you...
Medical Solutions
Omaha, NE5 days ago $120k
...Denial Compliance oversees the denial process within the utilization management (UM) department, ensuring that all denials are... ...evaluations, and discipline. Collaborate with medical directors, physician reviewers, and other UM/PA teams to coordinate denial decisions....Full timeCasual workRegal Medical Group
Los Angeles, CA28 days ago- ...accomplished Board Certified Orthopedic Surgeon physician ? Are you passionate about your work/... ...: Relying on clinical background, reviews health claims providing medical... ...files and provides recommendations for utilization review, chart reviews, medical necessity...Temporary workFor contractorsRemote workMonday to FridayFlexible hours
Concentra Careers
United States21 hours ago - ...A healthcare services company in Atlanta is seeking a Review Nurse to conduct prior approval and precertification reviews for Medicaid members. The role involves evaluating clinical information, documenting decisions, and collaborating with team members. The ideal candidate...
Alliant Health Group
Atlanta, GA4 days ago $72.5k - $105k
...POSITION SUMMARY: The Nurse Manager for Utilization Review and Clinical Appeal Management is responsible for overseeing the daily operations of the Utilization Management (UM) and Clinical Appeal teams. This role ensures compliance with hospital policies, regulatory...Full timeFixed term contractFlexible hoursWeekend workAfternoon shift$238k - $357.5k
...with a Fortune 4 industry leader. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance... ...responsible for conducting hospital and post-acute utilization reviews for the state of California. The Medical Directors work with...Minimum wageWork experience placementLocal areaRemote workOptum
Los Angeles, CA4 days ago- ...Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-... ...Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical...Price workExtra incomeContract workFor contractorsRemote workFlexible hours
$98.2k - $130.8k
...completion and approval of all clinical utilization documentation, including Start of Care,... ...roles. Works under general supervision. • Reviews and approves evaluation documentation,... ...change in the patient's condition, at the physician's request and after hospital discharge....Work experience placementWork at officeVNS Health
New York, NY4 days ago- ...clinical and strategic leader for Integra’s Utilization Management (UM) and Credentialing... ...per week leadership role that must be the physician’s primary professional responsibility, requiring... ...clinical oversight to the Utilization Review Medical Director(s), ensures consistent...Full timeContract workTemporary workLocal areaRemote work
