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- Utilization Review Nurse at CareWell Health Medical Center Job Summary The Utilization Review Nurse is responsible for ensuring that patients receive appropriate, cost‑effective care by reviewing medical records, treatment plans, and healthcare services. The role involves...SuggestedFull timeWork experience placement
$26.5 - $47.59 per hour
Utilization Review Nurse I You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh...SuggestedHourly payFull timePart timeWork at officeRemote workFlexible hours$95k - $105k
Utilization Review Nurse VillageCare is looking for a self‑motivated and passionate RN for a full‑time, 100% remote position. Location: Must reside within the New York Tri‑State Area (NY, NJ, or CT). From the comfort of your own home, you will be responsible for the...SuggestedFull timeRemote work- Drug Utilization Review Pharmacist - Ensure Safe and Effective Use of Medications A confidential managed care organization is seeking a skilled Drug Utilization Review (DUR) Pharmacist to support quality prescribing and improve patient outcomes. This role is ideal for...SuggestedRemote work
- ...5 applicants Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers... ...and Workers' Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental...SuggestedPrice workExtra incomeContract workFor contractorsRemote workFlexible hours
$26.5 - $47.59 per hour
Position Purpose Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines... ...behavioral health member data to improve quality and appropriate utilization of services. Provides education to providers, members and...SuggestedHourly payContract workWork at officeRemote workFlexible hoursWeekend workDay shift- Under the direction of the Supervisor, the Behavioral Health Utilization Management Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and experience, the clinician reviews provider requests for inpatient and outpatient services,...SuggestedWork at officeRemote workMonday to FridayFlexible hoursWeekend work
- Overview Dane Street, a leading Independent Review Organization (IRO) and national provider of Utilization Review (UR) services, is expanding our physician panel. We are seeking Board-Certified Orthopedic Spine Surgeons with an active New York medical license to perform...SuggestedExtra incomeContract workFor contractorsRemote workFlexible hours
- Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently... ...and Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering...SuggestedPrice workExtra incomeFor contractorsRemote workFlexible hours
- Under the supervision of the Manager for Utilization Management, this position is responsible for providing daily oversight of Utilization Management Reviewers, Utilization Management Review Technicians and staff members within Utilization Management. Responsibilities...SuggestedWork at officeRemote workMonday to FridayFlexible hoursWeekend work
- Utilization Review Coordinator Per Diem Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per Diem to coordinate and direct Utilization Review functions, monitoring the utilization and continuum of services to optimize reimbursement. Coastal...SuggestedDaily paidTemporary workReliefLocal area
- ...About Dane Street: Dane Street is a leading Independent Review Organization (IRO) and national provider of Utilization Review services. As we continue to expand our physician panel, we’re offering flexible, remote opportunities for board-certified physicians seeking...SuggestedExtra incomeContract workFor contractorsRemote workFlexible hours
- ...Dane Street, a nationally recognized Independent Review Organization (IRO) and a leading provider of Utilization Review (UR) services, is expanding our panel of expert physicians. We are currently seeking Board-Certified Occupational Medicine Physicians with an active...SuggestedExtra incomeContract workRemote workFlexible hours
- ...the Long Term Services and Supports (LTSS) Supervisor, the LTSS Reviewer is responsible for completing care and service needs reviews.... ...date that the request was received, nature of the request, utilization determination (and events leading up to the determination). Verifies...SuggestedRemote workFlexible hours
$100k - $140k
...to join our talented team at our office located in Somerset, New Jersey . In this role, you will be assigned to projects to review, coordinate, and summarize the activities of cost control, planning and scheduling, document control, and estimating. Additional...SuggestedFor subcontractorWork from homeHome officeIPS-Integrated Project Services
Somerset, NJ6 days ago$100k - $140k
...to join our talented team at our office located in Somerset, New Jersey . In this role, you will be assigned to projects to review, coordinate, and summarize the activities of cost control, planning and scheduling, document control, and estimating. You will also...Contract workFor subcontractorWork from homeHome officeIPS-Integrated Project Services
Somerset, NJ6 days ago$162k - $190.6k
...analytics platforms. This role will focus on supporting our Energy & Utilities clients as they evaluate, leverage, migrate to, and build on... ...by sending an email to ****@*****.*** . Please review our current policy regarding use of generative artificial...Full timeWork experience placementLocal areaImmediate startFlexible hoursWest Monroe
New York, NY15 hours ago$90.75k
...served, services provided, and analysis of surveillance data. Utilizes epidemiologic principles to conduct surveillance plan as... ...and healthcare workers across the organization as assigned. Review sterilization and disinfection policies and procedures, identifies...Hourly payFull timePart timeApprenticeshipWork experience placementLocal areaShift workNight shiftWeekend workAfternoon shiftHackensack Meridian Health
Perth Amboy, NJ4 days ago- ...Formulary Strategy & Utilization Review Pharmacist Shape the drug benefit landscape—analyze and optimize medication use. Key Responsibilities: Review prescribing trends and propose cost-saving alternatives. Maintain evidence-based formularies across multiple...
$90.75k
...& implement data driven strategies to ensure team's success. Utilize the Quality Scorecard to drive improvements by the HMH initiative... ...b. NJS and Federal Codes (i.e.: DOH, OSHA) c. Professional review organizations. Effective trend analysis of performance data with...Local areaDay shift- ...staff services. Assesses and communicates recommendations for utilization of space, space needs, equipment, personnel and other resources... ...to physician issues. Responsible for assuring a robust peer review and credentialing process, ensuring quality, safety, service and...
$24 - $25 per hour
...weekly/monthly reports on time. Analyze and balance inventory, review gain/loss, investigate variances, and ensure product movement... .... Identify and correct undocumented product movements and utilize the inventory system to respond to inquiries. Maintain inventory...Contract workTemporary work$18.5 - $19 per hour
...Protection Leadership team. This position will assist with daily video reviews, high value investigations, and various other special projects... .... Proficiency with Mac OS and Google Suite Proficient in utilizing CCTV. Compensation, Benefits, + Perks Employee Stock Purchase...Hourly payFlexible hoursWeekend workAfternoon shift$45k - $71.55k
...Provides for the safety and well-being of team members; effectively utilizes the Security Operations Center. + Complies with all company... ...relevant factors. This role will remain open until filled. To review benefits, please click here jobs.walgreens.com/benefits . If you...Full timeTemporary workInternshipWork at officeLocal areaRelocationFlexible hoursShift workWeekend workAfternoon shift$65k - $75k
...15% Drives Results: Maintains inventory accuracy and control; reviews reports identifies area of improvement for key metrics inclouding... ...others while coaching and developing talent. Financial Acumen: Utilizes fundamental concepts of finance to assist with managing budgets...Hourly payFull timeWork experience placementWork at officeRelocationShift workNight shift$20.5 - $27.5 per hour
...pharmacy, in accordance with state, federal, and company policy. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct.... ...Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring...Hourly payWork experience placementLocal areaImmediate startFlexible hoursAfternoon shift$75k - $140k
...retention, and EPS, through consistent execution of LEAD Plays. Utilize data and insights to identify opportunities and make... ...disability, employee stock purchase plan, and life insurance. To review available benefits, please click here: Compensation depends on...Minimum wageTemporary workFor contractorsWork experience placementLocal area- ...pharmacy, in accordance with state, federal, and company policy. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct. +... ...Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information,...Hourly payFull timeWork experience placementWork at officeLocal areaImmediate startFlexible hoursShift workAfternoon shift
$98.2k - $130.8k
...Overview Oversees the completion and approval of all clinical utilization documentation, including Start of Care, Re-certification,... ...engagement in all roles. Works under general supervision. • Reviews and approves evaluation documentation, OASIS and Patient Plan...Work experience placementWork at office- ...pharmacy, in accordance with state, federal, and company policy. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct. +... ...Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information,...Hourly payApprenticeshipWork experience placementWork at officeLocal areaImmediate startFlexible hoursShift workAfternoon shift
