Average salary: $62,258 /yearly
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$19 - $20 per hour
...Health Payer to facilitate information sharing and successful process completion within allocated timeframe. Review timely filing guidelines regarding the utilization management process. Track and follow up with payers on pending authorizations to ensure timely responses....SuggestedHourly payFull timeTemporary workImmediate startRemote workShift work$20 per hour
...brand are highly recognized and respected for our strong commitment to quality and safety. We are America’s leader in underground utility damage prevention and advanced infrastructure services, performing more than 84 million locates each year for the more than 1,400 telecommunications...SuggestedHourly payExtra incomeFull timeFor contractorsShift workNight shift$47.67k
...7 Agency: Public Service Commission Working Title: PUBLIC UTILITY ANALYST I - 61000038 Pay Plan: Career Service Position Number... ...and Performance Analysis (APA) is responsible for technical reviews in all industries, and may include financial, compliance, management...SuggestedFull timeWork experience placementWork at officeFlexible hours$105.1k - $192.6k
...career wherever you want it to go. Join EY and help to build a better working world. Tax - Indirect Tax - Sales & Use Lookback Review COE - Manager Will you shape the future or will the future shape you? The opportunity Our Sales and Use Tax Lookback Review...SuggestedFull timeSummer holidayFlexible hours$95k - $110k
...Sign-on bonuses are available for highly qualified candidates. Summary We are seeking a talented individual for a DRG Nurse Reviewer Appeals and Hearings to coordinate and perform all appeal related duties including analyzing and responding appropriately to appeals...SuggestedFull timeRemote workWork from homeRelocation packageFlexible hours- ...We’re looking for an organized and dependable Utilization Management Assistant to join New Paradigm Staffing, helping clinical and insurance teams manage medical necessity reviews. This role is perfect for someone who wants exposure to the clinical-review side of...SuggestedFull timeRemote work
- ...We’re looking for a detail-oriented and motivated Remote Utilization Management Support Clerk to join New Paradigm Staffing, a growing... ...someone who enjoys organization, documentation, and supporting care review processes. What You’ll Do Gather clinical documents...SuggestedFull timeRemote work
- ...We’re looking for a detail-focused Entry-Level Documentation Quality Reviewer to join New Paradigm Staffing , ensuring healthcare documents meet quality and compliance standards. This role is perfect for someone who enjoys reviewing text and identifying errors....SuggestedFull timeRemote work
- About the job Utilization Review Specialist Join Our Team: As a Utilization Review Specialist, you will play a pivotal role in managing and performing various processes related to medical records requests, retrospective review requests, and chart appeals. If you are organized...Suggested
- ...affiliated physician practices. HOW YOU'LL MAKE AN IMPACT Your Role: Conducts ongoing pre-certification, concurrent, and retrospective reviews on the Tallahassee Memorial Behavioral Health Center (TMBHC) inpatient population. Coordinates reviews with the respective...SuggestedSecond jobWork at office
- ...forward‑thinking philosophy that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence. The Utilization Review Specialist Senior responsibilities include: Functions as the primary liaison between the funding agents and all other...SuggestedReliefWeekend work
- Universal Hospital Services Inc. is seeking a Utilization Review Coordinator in Orlando, Florida. The role involves conducting assessments, ensuring optimal patient care, and coordinating with various stakeholders to maintain documentation quality. The ideal candidate...Suggested
$31.94 - $43.92 per hour
...Create and manage discharge plans Coordinate with MDs, nurses, and social workers Lead care planning discussions Utilization Management Review medical necessity & admission status Ensure correct level of care (IP vs Observation) Communicate with insurance/...SuggestedRelocation packageShift workWeekend workAfternoon shiftLancesoft INC
Tallahassee, FL27 days ago- Central Florida Behavioral Hospital in Orlando, FL is seeking a Utilization Review Coordinator. This role involves conducting psychosocial assessments, coordinating with families, and ensuring quality patient care through effective communication. The ideal candidate will...Suggested
- Universal Health Services, located in Orlando, FL, is seeking a Utilization Review Coordinator to ensure optimal quality of patient care. The coordinator will perform admission and concurrent reviews while closely collaborating with healthcare professionals. Ideal candidates...Suggested
- Tallahassee Memorial HealthCare is seeking a qualified individual to conduct reviews at the Tallahassee Memorial Behavioral Health Center. Responsibilities include pre-certification and liaising with insurance companies to ensure proper admissions and stays. A Bachelor'...
- Tallahassee Memorial HealthCare, Inc. is seeking a qualified professional to conduct ongoing certification and reviews for the behavioral health inpatient population. This role involves coordinating with insurance for admission certifications and working directly with psychiatrists...
- 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 Manager Exact Billing Solutions Lauderdale Lakes, FL (Full-Time/ On-site) Who We Are Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental health, and autism...Full timeFlexible hours
$71.2k - $127.2k
A healthcare institution in Leesburg, Florida is seeking a Utilization Review Nurse to assess hospital admissions and resource utilization. The role involves ensuring timely patient discharges and upholding accurate medical documentation. The ideal candidate will possess...ReliefShift work- A large healthcare provider in Tampa is seeking a Utilization Review Specialist Senior. This hybrid position involves acting as a liaison for funding agents and ensuring appropriate levels of care through comprehensive reviews. Candidates must have a Registered Nurse license...Weekend work
$29.05 - $67.97 per hour
Molina Healthcare in Orlando, Florida is looking for a clinical professional to review documentation, ensuring medical necessity and appropriate reimbursement. You'll facilitate appeals for denied prior authorizations and validate the medical record. Desired candidates...Hourly pay- Molina Healthcare is seeking a Registered Nurse for clinical review in Miami, Florida. This role involves ensuring medical necessity... ...have 2+ years in clinical nursing, including experience in utilization review. Skills in coding and regulatory compliance are essential...
$29.05 - $67.97 per hour
Molina Healthcare in Jacksonville, FL, is seeking a Clinical Nurse Reviewer to ensure medical necessity and care level through detailed documentation review. You will work on prospective, retrospective, and concurrent reviews of claims while collaborating with clinicians...Hourly pay- A leading U.S. healthcare company seeks a Medical Director in Tallahassee, Florida. The role includes clinical reviews and analysis of inpatient cases, requiring MD or DO credentials and 5+ years of experience. Ideal candidates possess strong analytical skills and can effectively...Remote job
$60k - $75k
...Billing Solutions delivers hands-on, process-driven operational support to behavioral health programs. We are looking for a Utilization Review (UR) Specialist in Boca Raton, FL Compensation: $60,000 - $75,000 a year - (Based on experience) Full-time Why Join...Full timeWork at officeRemote work$80k - $85k
Utilization Review Nurse | Corporate Utilization Management | PRN | Variable - UF Health Overview FTE‑.10 PRN Variable shift The Utilization Review Nurse is responsible for evaluating the appropriateness of hospital admissions, resource utilization, and medical necessity...Full timeReliefShift work$26.41 - $51.49 per hour
Molina Healthcare in Florida seeks a support specialist for member clinical review processes focused on applied behavioral analysis (ABA) services. Responsibilities include assessing ABA services, analyzing clinical requests, and collaborating with care management. Required...Hourly pay$55k - $70k
...Job Description Job Description 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...Remote workFlexible hours$26.41 - $51.49 per hour
Molina Healthcare seeks a Candidate to provide support for member clinical reviews related to ABA services. Responsibilities include assessing ABA services for compliance, analyzing requests, and collaborating with care management. Required qualifications include adequate...Hourly pay
