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Utilization Review Coordinator Jobs

5,646 Jobs

  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    HOT
    Consistently relates utilization assessment to payers that are needed to justify continued stay review and to obtain pre-certification… care. Evaluates effectiveness of care and facilitates coordination of care toward specific outcomes criteria. Maintains timely…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    24 days ago 24d
    Consistently relates utilization assessment to payers that are needed to justify continued stay review and to obtain pre-certification… care. Evaluates effectiveness of care and facilitates coordination of care toward specific outcomes criteria. Maintains timely…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    $57k-$72k(Glassdoor est.)
    26 days ago 26d
    Consistently relates utilization assessment to payers that are needed to justify continued stay review and to obtain pre-certification… care. Evaluates effectiveness of care and facilitates coordination of care toward specific outcomes criteria. Maintains timely…
  • 3.5
    Commonwealth Care Alliance – Boston, MA
    11 days ago 11d
    The Utilization Management (UM) Review Nurse is responsible for day-to-day timely clinical and service authorization review for… organizational determinations. The Utilization Management Review Nurse reports to the Utilization Management Nurse Manager. Key…
  • 3.7
    Dignity Health – Rancho Cordova, CA
    $102k-$133k(Glassdoor est.)
    12 days ago 12d
    Responsibilities Position Summary: The UtilizationReview RN will review medical records, benefit, contractual and other… Microsoft Windows systems Keyboarding skills and the ability to utilize computer equipment and software, and experience with other…
  • 3.1
    MemorialCare Health System – Fountain Valley, CA
    12 days ago 12d
    complex clinical, benefit and network decisions. Apply UtilizationReview Management process to ensure continuity of care throughout… necessity review. Follow all department P&Ps as applicable to job. Demonstrate the ability to consistently utilize the computer…
  • 3.9
    LifeNet Health – Renton, WA
    6 days ago 6d
    Full-Time ReviewCoordinator to join the LifeNet Health team in our Renton, WA location. As a ReviewCoordinator, you would… appropriate manner. Coordinates the daily flow of records to M.D. for review prioritizing chart review to meet production and…
  • 2.7
    Boys Town Hospital – Omaha, NE
    $51k-$66k(Glassdoor est.)
    27 days ago 27d
    administrative duties pertaining to utilizationreview, audit, billing and reimbursement activities, utilizing knowledge of both nursing… and accountable for the management of utilizationreview through ensuring timely review of all hospital admissions and insurance…
  • 3.6
    Florida Hospital – Orlando, FL
    HOT
    psychiatric utilization care managers and payer mix. The UtilizationReview Specialist provides comprehensive knowledge and leadership… concurrent daily reviews for admissions and continued stays according to specified criteria by the UtilizationReview and Care Management…
  • 4.6
    Unified Investigations & Sciences – Memphis, TN
    5 days ago 5d
    Job Title: UtilizationReviewCoordinator - Memphis Location: Memphis, TN Position Type: Regular - Full Time… Job Description: UtilizationReviewCoordinator CLAIM YOUR FUTURE AS A GREAT PERFORMER! Providing both satisfying…
  • 3.7
    Scripps Health – La Jolla, CA
    $47k-$64k(Glassdoor est.)
    5 days ago 5d
    Director. Supports the development, utilization, implantation, and monitoring of utilizationreview/performance improvement projects… admission, concurrent, and retrospective case review for all payor sources. Reviews all admissions for appropriate level of care…
  • 3.8
    National Coalition of Healthcare Recruiters – Walnut Creek, CA
    NEW
    acute care experience. Under general supervision, coordinates assigned utilization, discharge planning, data flow, and case management… management activities in an acute care hospital or performs utilization and case management activities in an outpatient mental health…
  • 3.8
    National Coalition of Healthcare Recruiters – Walnut Creek, CA
    NEW
  • 4.0
    Onward Behavioral Health – Wilkinsburg, PA
    5 days ago 5d
    Posted on UtilizationReviewCoordinator Pyramid Healthcare, Inc in Wilkinsburg, PA 15221 USA Benefits Offered 401K,… obtain information for client reviews. Maintain daily UR database accurately. Perform Act 106 reviews and follow up appeals. Track…
  • 4.2
    Bronson Healthcare – Kalamazoo, MI
    4 days ago 4d
    HospitalTitleUtilization ReviewCoordinator Responsible for fulfilling the Hospital Utilization Management policies and procedures… . • Maintains complete, accurate documentation of all utilizationreview activities • Meets with physicians to evaluate patient…
  • 3.5
    Providence Health & Services – United States
    6 days ago 6d
    Providence is calling a UtilizationReviewCoordinator (1.0 FTE, Rotating/Day) to work at either Providence Portland Medical Center… medical/surgical care setting -or- 5 years of current UtilizationReview or Case Management experience Preferred qualifications…
  • 3.1
    Next Level Health Partners, LLC – Chicago, IL
    EASY APPLY
    $53k-$71k(Glassdoor est.)
    7 days ago 7d
    level of care reviews for requested services using clinical judgment and refer to Medical Director(s) for review depending on case… electronically, telephonically, or onsite to coordinate member care. Conduct and coordinate discharge planning with assigned case…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    20 days ago 20d
    Consistently relates utilization assessment to payers that are needed to justify continued stay review and to obtain pre-certification… care. Evaluates effectiveness of care and facilitates coordination of care toward specific outcomes criteria. Maintains timely…
  • 3.1
    LECOM Health and Wellness Center – Erie, PA
    5 days ago 5d
    Hospital is seeking a full time UtilizationreviewCoordinator for 1st shift. SUMMARY: Reviews medical records to determine… Minimum Experience: A minimum of 1 year experience in UtilizationReview/Case Management or a related field…
  • 4.6
    Paramount Residential Mortgage Group – Corona, CA
    EASY APPLY
    6 days ago 6d
    through a full array of products and services. Coordination: Utilizes business development skills to establish new business… applications and packages to and within the company. Assist in review, setup, due diligence of loan broker package submissions, ensuring…
  • 4.0
    PeraHealth – Charlotte, NC
    EASY APPLY
    HOT
    of Philadelphia and Memorial Sloan Kettering Cancer Center utilize PeraHealth’s real-time, predictive analytics to improve quality… international travel and accommodations, preparing, processing and reviewing expense reports, maintaining CEO’s filing system, and arranging…
  • 2.8
    Fortis Management Group – Traverse City, MI
    $41k-$52k(Glassdoor est.)
    NEW
    IND1 POSITION SUMMARY: The RAI Coordinator position is responsible for the coordination of the Resident Assessment Instrument… ensure the most appropriate assessment reference date (ARD) is utilized for Medicare assessments through the use of the PPS Pathway…
  • 3.1
    Next Level Health Partners, LLC – Chicago, IL
    EASY APPLY
    7 days ago 7d
    level of care reviews for requested services using clinical judgment and refer to Medical Director(s) for review depending on case… electronically, telephonically, or onsite to coordinate member care. Conduct and coordinate discharge planning with assigned case…
  • 2.9
    Sedgwick Claims Management Services Inc – Memphis, TN
    NEW
    UtilizationReviewCoordinator CLAIM YOUR FUTURE AS A GREAT PERFORMER! Providing both satisfying and challenging work… "Claim Your Future." PRIMARY PURPOSE: To assign utilizationreview requests; to verify and enter data in appropriate system…
  • 3.4
    Swedish Medical Center – Englewood, CO
    NEW
    Position Summary: The Utilitization ReviewCoordinator has responsibility for timely and accurate verification of insurance… insurance and authorization for hospital days; coordinates initial and continued stay reviews from Case Managers and business office as…
  • 2.9
    Pennsylvania Psychiatric Institute – Harrisburg, PA
    EASY APPLY
    NEW
    Proactively monitors the utilization of continuum of services and interfaces with third party payors in certifying coverage.…
  • 2.9
    Sedgwick – United States
    7 days ago 7d
    Job Title: UtilizationReviewCoordinator - Memphis Location: Memphis, TN Position Type: Regular - Full Time… Job Description: UtilizationReviewCoordinator CLAIM YOUR FUTURE AS A GREAT PERFORMER! Providing both satisfying…
  • 3.5
    Blue Cross and Blue Shield of Massachusetts – Quincy, MA
    6 days ago 6d
    retrospective reviews when indicated and as allowed, for applicable product lines and levels of care, with emphasis on utilization management… happens here.This position is a UM Reviewer for Medicare Advantage. Reviewer conducts reviews for all levels of care for inpatient…
  • 2.6
    The Mentor Network – Brighton, MA
    5 days ago 5d
    UtilizationReviewCoordinator Primary Location: MA-MABrighton-1284 Soldiers Field Rd Function: Program Services Coordination/… support the seniors and adults we serve. As a UtilizationReviewCoordinator (URC) with Revel Adult Day Health, youll be one…
  • 3.1
    HonorHealth – Scottsdale, AZ
    $64k-$79k(Glassdoor est.)
    6 days ago 6d
    Job Details POSITION SUMMARY Reviews and monitors utilization of health care services with the goal of maintaining… comprehensive review for medical necessity of extended stay, outpatient observation, and inpatient stays and the utilization of ancillary…
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