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
- 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
- ...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
- ...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
- ...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
Florida7 days ago - 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
$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...Suggested- ...other related parties to ensure appropriate level of care through comprehensive concurrent review for medical necessity of outpatient observation and inpatient stays and the utilization of ancillary services Perform other duties as assigned by the supervisor including but...SuggestedFull timeReliefWeekend work
- 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...SuggestedFull timeTemporary workWork at officeWorldwide
$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...Suggested- ...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...SuggestedFull timeMonday to FridayFlexible hours
- 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
- A large healthcare provider in Florida seeks an experienced Education Coordinator for Utilization Review and Denials Management. This full-time, hybrid position requires a Bachelor's Degree in Nursing and certifications within a year. Responsibilities include developing...Full time
- A prominent healthcare provider in Tampa is seeking a Utilization Review RN. The position is hybrid and requires an active RN certification along with 2 years in Utilization Review and 3 years as a Registered Nurse. Ideal candidates will have experience in Critical Care...Relief
$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...- A leading behavioral health organization in Leesburg, FL, seeks a Utilization Review Manager - RN to oversee the utilization review process, ensuring patient care services are optimized and compliant with standards. The ideal candidate possesses a current RN license in...
- The Case Manager / Utilization Review / Swing Bed Coordinator (CM) will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care, and resource management. The CM will...Work at office
$65k - $100k
...our website, please only use or . Additionally, our recruiters utilize email addresses with the @lifestance.com domain. Other... ...status should not be sent to this email address as they will not be reviewed or responded to. To apply for a position, please use our official...Full timeFlexible hoursLifeStance Health
Florida1 day ago$200k - $230k
...Vice President of Utilization Review – Exact Billing Solutions (EBS) Lauderdale Lakes, FL - In Office - No Remote Salary Range: $200K - $230K This is a full-time, on-site role requiring daily presence at our Lauderdale Lakes, FL location. Who We Are...Full timeWork at officeRemote workFlexible hours- ...to the credit requirements of designated customer accounts. Review files, reports, and credit bureau documents, and financial statements... ...from customers for the development of a response to the Public Utility Commission, consumer advocates, media, and management....Full timeFlexible hours
- ...they're doing! We're committed to bringing passion and customer focus to the business. Job Summary: The Utilization Review Nurse will support the clinical review operations needed to assist our membership. This position is a member of a team of...
- ...Onboarding of new Team Members includes Interviewing, selection, and review of Wisely pay card, uniforms, and training schedule ✓ BOH... ...through managing the P&Ls ✓ Ensures Zenput is being utilized. All tasks completed in Zenput ✓ Manager Meetings/Team Meetings...
$89k - $134k
...coaching and mentoring and help them find solutions. Retrieve, review, and monitor metrics, reports, process documentation, customer... ...trucks and trailers. Fleet Services also services customers utilizing its 50+ nationwide service centers; each offering accident repair...Full timeCurrently hiringFleet Services by Cox Automotive
Florida13 days ago- ...com. Visit for full details and additional Case Management/Utilization Management opportunities. Feel free to share this information... ...Firms – Forbes 2025 Top 10 U.S. Search Firm – Executive Search Review Member of the Sanford Rose Associates® network of offices...Full time
- ...Software Engineer III are pivotal to the success of projects, utilizing software development tools under limited supervision and adhering... ...and enforcing coding best practices, performing code reviews, and ensuring quality delivery and procedural compliance....Full time
- ...Additionally: ensures compliance with Federal, State, and local laws and regulations. May also advise physicians on medication utilization. Review and monitor patient's medication therapy and orders written for safety and efficacy considering specific patient conditions...Full timeLocal areaFlexible hours
