Average salary: $57,301 /yearly
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- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care using nationally recognized acute care indicators...SuggestedRemote jobPermanent employmentWork experience placementReliefLocal area
$40k
...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- Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right...SuggestedRemote work
$90k - $99k
...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
- ...information or to view all of our job opportunities, please visit our website We are seeking a Senior Quality Engineer TRB (Technical Review Board) Lead to join our team. This role will involve leading cross-functional technical reviews, ensuring quality and regulatory...SuggestedRemote work
- ...contracted independent practices. Annual revenues last year exceeded $2 billion. This exceptional position will oversee the group's Utilization management program either from the group's Headquarters in San Antonio, Texas or it may be managed from the home city of the...SuggestedRemote 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
- ...patient vital signs, TB tests when required, and collects data for review by Medical Director or RN. Schedules and screens patients to... ...: Use primarily when operating hands to medicate patients, utilize keyboard and telephone. Talking: To convey detailed or...SuggestedLocal area
New Season
Florida10 days ago - ...Job Description will also apply at Broward Pace Program sites. Job Summary The Utilization Nurse is responsible for conducting prospective, concurrent, and retrospective clinical reviews to determine medical necessity, level of care, and appropriateness of services across...SuggestedFull timePart timeWork at officeLocal areaRemote workWeekend workAfternoon shift
- ...as medication management, case management, and counseling. Job Summary Mental Health Resource Center is looking for a Utilization Management Reviewer to monitor the utilization of clinical services provided at Mental Health Resource Center (MHRC), using predetermined criteria...SuggestedFull timeMonday to FridayFlexible hours
- 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
- ...and concurrent insurance authorizations Conduct peer-to-peer reviews as needed Review clinical documentation to ensure alignment with... ..., admissions, and billing teams Qualifications 3+ years utilization review experience in behavioral health, substance use, detox,...Suggested
$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...SuggestedFull timeTemporary workLocal areaFlexible hoursShift work- ...participants in Miami-Dade and Broward counties. This Job Description also applies at Broward Pace Program sites. Job Summary The Utilization Review Analyst supports the Florida PACE Centers’ UM Program by combining administrative expertise with analytical skills to...Full timePart timeLocal areaShift work
$76k - $85k
...challenges, pursue opportunities, and serve constituents across the public sector. To learn more, visit PCG is currently seeking a Utilization Review Nurse. The Utilization nurse will also be responsible for utilizing a medical management software system on a day-to-day...For contractorsH1bWork at officeLocal areaRemote work- A private psychiatric center in Orlando, FL, is seeking a Utilization Review Coordinator. The role involves admission and concurrent review of patients to ensure high-quality care is delivered cost-effectively. Candidates should have a Master's Degree in Psychology or...
- Responsibilities We are pleased to announce the following available position: FT Utilization Review Coordinator, including weekends. This position is responsible for monitoring the treatment activities offered to the patient, interfacing with the treatment team/managed...Local area
- Responsibilities We are pleased to announce the following available position: FT Utilization Review Coordinator, including weekends. This position is responsible for monitoring the treatment activities offered to the patient, interfacing with the treatment team/managed...Local area
- Case Manager RN - Utilization Review page is loaded## Case Manager RN - Utilization Reviewremote type: Remotelocations: Miami, FLtime type: Full timeposted on: Posted Todayjob requisition id: R100093085**Current Employees:**If you are a current Staff, Faculty or Temporary...Full timeTemporary workWork at officeWorldwide
- A leading psychiatric healthcare provider in Orlando, FL, seeks a Utilization Review Coordinator responsible for admission and concurrent patient reviews, ensuring quality documentation. Ideal candidates hold a Master's in Psychology or related fields and possess 3-5 years...
- A private psychiatric center in Orlando, FL is looking for a Utilization Review Coordinator to perform patient admission and concurrent reviews. The ideal candidate will ensure quality patient care and collaborate closely with physicians. Qualifications include a Master...
- A leading healthcare provider located in Orlando, FL, is looking for a Utilization Review Coordinator to perform admission and concurrent reviews of patients. The candidate should have a Master’s Degree in a relevant field and 3-5 years of experience in utilization review...
$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- ...that’s built on a foundation of trust, dignity, respect, responsibility and clinical excellence. The Education Coordinator-Utilization Review and Denials Management Responsibilities include: Collaborating and working with the Utilization Review and Clinical Denials...Full timeWork at officeMonday to FridayShift workWeekend work
- ...Case Manager for a role in Hudson, Florida. This 13-week position involves working with healthcare professionals and overseeing utilization reviews. Candidates should have a valid RN license and experience in travel nursing. The job offers comprehensive benefits, including...
- A leading healthcare provider in Miami is seeking a Utilization Nurse responsible for conducting clinical reviews to ensure the appropriateness of services for aging adults. The role requires collaboration with hospitals and healthcare teams, maintaining compliance with...Remote job
- A leading behavioral health organization in West Palm Beach seeks a Utilization Review Specialist to obtain and manage insurance authorizations and conduct peer reviews. The ideal candidate has over 3 years of experience in behavioral health settings, strong communication...
- A leading educational institution in Miami is seeking a Case Manager RN for Utilization Review. The role involves conducting medical necessity chart reviews and coordinating with the healthcare team to ensure optimal patient outcomes. The ideal candidate will have a Bachelor...Remote jobFull time
