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- RN-Utilization Review Nurse Inpatient *Full Time - 100% Remote Opportunity* Must reside within the New York Tri-State Area - NY, NJ, or CT COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE! VillageCare is looking for a self-motivated and passionate RN...Suggested
- ...that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff. Website: The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical...Suggested
$65 per hour
...coordinate patient care, manage resources, and ensure appropriate utilization of healthcare services while maintaining high-quality patient... ...care planning and discharge planning. Conduct utilization review to ensure appropriate level of care and services. Collaborate...Suggested- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving...Suggested
- ...plan of care for members based on authorization and concurrent review. Provides monthly telephonic outreach to ensure members needs are... ...network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards,...SuggestedContract workRemote workMonday to FridayFlexible hours
- Job No: 497118 Department: Medical Care Review Local Title: Utilization Review Nurse Budget Title: Teaching Hospital Quality Assurance Senior Coordinator Work Type: Full Time Location: Brooklyn, NY Categories: Administrative, Nursing, Patient Care Job Summary The...SuggestedFull timeReliefLocal areaMonday to Friday
$24 - $56.17 per hour
A prominent healthcare provider based in New York is seeking a professional to provide support for clinical member services review processes. The role involves ensuring services are medically necessary and compliant with established guidelines. Candidates should possess...Suggested- A leading behavioral health facility in Georgia is seeking a Utilization Review Coordinator to join their Case Management team. This role requires a Master's level education in social science and must also be licensed or license-eligible in Georgia. The ideal candidate...Suggested
- Overview Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers.... ...license and Workers’ Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering...Suggested
- A healthcare facility in Augusta, Georgia, is seeking a Utilization Review Coordinator to join their Case Management team. The role involves reviewing clinical data, collaborating with medical staff, and ensuring compliance with insurance authorization processes. Ideal...Suggested
- ...organization in New York, NY is seeking a Durable Medical Equipment Review Coordinator to ensure high quality, cost-effective services... ...least two years of managed care experience. Familiarity with utilization management and case management is strongly preferred. This...Suggested
- A healthcare organization is seeking an experienced Registered Nurse (RN) - Case Management for their New York location. The RN will be responsible for coordinating patient care, managing resources, and ensuring high-quality patient outcomes. Key responsibilities include...Suggested
- A leading managed care organization is seeking a self-motivated RN for a fully remote Utilization Review Nurse position. Responsibilities include assessing member needs, ensuring medical necessity of services, and collaborating with healthcare professionals. Candidates...SuggestedRemote job
- Joe Knows Energy is seeking an experienced Technical Reviewer to support gas distribution construction projects in Spring Valley, NY. This... ...submissions for accuracy, completeness, and compliance with utility standards. The ideal candidate understands utility construction...Suggested
- A recognized Independent Review Organization is seeking Board-Certified Orthopedic Spine Surgeons for a remote Physician Reviewer role. This non-clinical position focuses on conducting utilization reviews without direct patient interaction. Responsibilities include reviewing...SuggestedRemote job
- An established industry player is seeking Board-Certified Orthopedic Spine Surgeons for a fully remote, non-clinical role in Utilization Review. This opportunity offers flexibility and supplemental income, allowing physicians to provide evidence-based opinions on treatment...Remote job
- The Per Diem Advanced Practice Nurse (APN) for Utilzation Review utilizes a patient-centered coordinated care model, demonstrating competencies in leadership, direct clinical practice, consultation/collaboration, coaching/guiding, research, and ethical decision-making....
$172.9k - $230.5k
...nonprofit healthcare organization in New York is seeking an experienced medical professional to oversee utilization management for members. The role includes reviewing clinical information, ensuring compliance with guidelines, and contributing to quality care...- Come lead with us at Houston Methodist Hospital 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...
$24 - $56.17 per hour
...support for clinical member services. The role involves assessing services for compliance with clinical guidelines and conducting reviews for prior authorization of services. Candidates should have at least 2 years of healthcare experience, clinical licensure if necessary...- Responsibilities 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 Harbor Health System is...
- A leading healthcare provider is seeking a Registered Nurse for their LTSS department in New York. This role involves providing case management services, evaluating medical services, and managing appeals for denied services. Candidates must possess a valid RN license in...Remote job
- A recognized Independent Review Organization is seeking a Board-Certified Psychiatrist for a fully remote role conducting Utilization Reviews. Candidates should have an active New York medical license and Workers’ Compensation Board Certification. Responsibilities include...Remote job
- A national leader in medical review services is seeking Board-Certified Orthopedic Spine Surgeons for a flexible, fully remote role. The position involves reviewing medical records and determining the medical necessity of treatment requests without patient interaction....Remote job
- A healthcare organization in New York seeks a motivated RN for the role of Supervisor of Utilization Management - Concurrent Review. This position involves overseeing the concurrent review and discharge planning processes for patients. Key responsibilities include supervising...
- A state mental health office in New York is seeking a Utilization Review Coordinator to analyze psychiatric services and ensure compliance with established criteria. Responsibilities include reviewing clinical records, collecting and analyzing data, and evaluating medical...Work at office
- A leading healthcare organization in New Jersey seeks a Per Diem Advanced Practice Nurse for Utilization Review. The role involves using a patient-centered coordinated care model and collaborating with the hospital team to address patient care needs. Required qualifications...Daily paid
- A leading healthcare provider is seeking a Utilization Review Nurse PRN to conduct medical record reviews and determine the appropriateness of inpatient services. The successful candidate will collaborate with case management and provide essential education to healthcare...
$75.12 per hour
A prominent healthcare organization in New Jersey seeks an Advanced Practice Nurse for Utilization Review. The role includes conducting patient assessments, prescribing medications, and collaborating on patient care plans. Suitable candidates must hold a Master's or Doctorate...- A healthcare provider located in Georgia is seeking a Utilization Review Coordinator Per Diem to manage the utilization review process and ensure compliance with health care regulations. Candidates should possess a master's degree in nursing or psychology and ideally have...Daily paid