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8474 utilization review Jobs

  • BlueCross BlueShield of Tennessee
    Clinical Review - Utilization Management
    Chattanooga, TN
    $44K - $101K (Glassdoor est.)
    4d
    Perform comprehensive clinical review of requested services utilizing clinical criteria, received through various …
  • MedStar Health Logo3.9
    Utilization Review Nurse
    Washington, DC
    $18 - $31 Per Hour(Glassdoor est.)
    4d

    General Summary of Position:

    • Under the direction of The Director of UM/Appeals assists in the …
  • MMQ Nurse
    Lowell, MA
    Easy Apply
    11d
    One to three years previous experience with case-mix utilization review preferred. …Reviews all pertinent documentation for accuracy and consistency…
  • Meridian Behavioral Health Logo3.1
    Utilization Review Coordinator / Managed Care - LADC
    New Brighton, MN
    $27K - $60K (Glassdoor est.)
    Easy Apply
    12d
    Utilization Review Coordinator / Managed Care Location: New Brighton, MN Meridian Behavioral Health LLC is a leader in behavioral health care…The Utilization Review Coordinator provides face-to-face…
  • Centurion Logo3.2
    Utilization Review Nurse
    Roseville, MN
    9d
    We are currently seeking a part-time Utilization Review Registered Nurse to join our team at the Regional Office located in Roseville, Minnesota…Available Shift Monday through Friday working 24 hours per week; open to discuss schedule Responsibilities The Utilization (UM…
  • Premier Health Logo3.7
    RN UR MGR-BSN-115
    Dayton, OH
    $22 - $40 Per Hour(Glassdoor est.)
    24h
    RN Utilization Review Manager- OneFifteenFull Time/ M-F 8:00am-4:30pm/ 80 hours per pay The Utilization Management RN is a registered nurse (RN…The RN is responsible for concurrent and retrospective reviews of patients admitted to the behavioral health inpatient units…
  • Ascension Logo3.9
    RN-Utilization Review Manager-Case Management
    Baltimore, MD
    $18K - $45K (Glassdoor est.)
    4d
    We Are Hiring: Hospital Utilization Review experience Not Remote Work Schedule… but not limited to: Access Authorization and pre-certification, utilization review and denial management, Care Coordination, Collaborative treatment planning and core measures, Discharge Planning, tracking of the post…
  • Ascension Logo3.9
    Registered Nurse (RN) - Utilization Review - Weekends
    Milwaukee, WI
    $16 - $30 Per Hour(Glassdoor est.)
    11d
    We Are Hiring: Registered Nurse (RN) - Utilization Review - PRN, Weekends - Ascension Columbia St…
  • Abramson Center for Jewish Life Logo3.5
    Full Time RN Intake Coordinator
    Jenkintown, PA
    $78K - $80K (Glassdoor est.)
    Easy Apply
    18d

    Based in Jenkintown (Montgomery County), Abramson Homecare has an exciting Full-Time RN Intake Coordinator

  • CPC Behavioral Healthcare Logo4.6
    Utilization Review Coordinator
    Eatontown, NJ
    $32K - $57K (Glassdoor est.)
    12d
    CPC Behavioral Healthcare is recruiting for a Utilization Review (UR) Coordinator. …
  • Bethesda Hospital, Inc. Logo4
    ED RN Case Manager
    Boynton Beach, FL
    $44K - $63K (Glassdoor est.)
    24h
    experience with a minimum of 1-3 years of hospital or payor Case management or Utilization management review experience preferred. …Is accountable for prioritizing, reviewing cases to determine the appropriateness of pre-admission, admission utilizing payer established criteria Assisting in identifying appropriate patient status and level of care…
  • Life Care Center of Port Townsend Logo3.1
    Care Manager (Registered Nurse/RN) | LPN Care Manager
    Port Townsend, WA
    Easy Apply
    24h
    ) year of clinical experience in post acute care setting preferred Prior case management, utilization review, and discharge planning experience preferred Certified Case Manager (CCM…
  • Utility Manager
    East Troy, WI
    Easy Apply
    24h
    Related keywords: utilization review nurse, registered nurse, rn, utilization review, nurse Job Type…
  • Vidant Health Logo3.5
    RN - Utilization Review Specialist - Potential for Sign On Bonus - Utilization Management
    Greenville, NC
    $15 - $29 Per Hour(Glassdoor est.)
    17d
    Position Summary The Utilization Review Specialist will ensure regulatory compliance with CMS Conditions of Participation with regard to Utilization Management…Perform Utilization Review according to CMS and commercial payor guidelines. …
  • Evening IOP Substance Abuse Therapist
    Crystal Lake, IL
    Easy Apply
    24h
    This position requires a knowledge and experience in addictions and mental health with the ability to make a diagnosis, work with medical staff and complete vital information for utilization review… and review treatment plans and perform counseling both individually and in group settings…
  • HealthStar Home Health Inc Logo4.1
    Director of Nursing / DON
    Saint Paul, MN
    Easy Apply
    21d
    Utilization Review. …Perform quality review of all nursing documentation. …Quality review of assessments, visit notes and other supporting documentation daily to ensure appropriateness, completeness, timeliness and accuracy…
  • Baystate Health Logo3.6
    Registered Nurse, Hospital Case Manager
    Springfield, MA
    $49K - $70K (Glassdoor est.)
    13d
    Thorough knowledge of Utilization Review concepts, resource management and reimbursement methodologies…Additional competencies include: Working knowledge of community resources and Utilization
  • Hampstead Hospital Logo3.6
    Utilization Review Clinician
    Hampstead, NH
    Easy Apply
    20d
    Description: Utilization review case manager needed for acute inpatient psychiatric…The ideal candidate must be familiar with all aspects of managed care and psychiatric-specific utilization review procedures…
  • Uphams Corner Health Committee Inc Logo3.1
    Social Worker LICSW/LMHC
    Boston, MA
    $28K - $48K (Glassdoor est.)
    Easy Apply
    4d
    Attending multidisciplinary treatment team meetings and Utilization Reviews Collaborating care with Primary Care and other departments as needed…
  • Aspen Valley Hospital Logo3.8
    Patient Navigator RN - Surgery
    Aspen, CO
    21d
    role with utilization review and discharge planning processes for orthopedic patients. …: Aspen Valley Hospital · UTIL Review/DISCH Planning Schedule: Full-Time…
  • Banyan Medical Systems Logo3.6
    RN Certified Case Manager, Days-Indirect Patient Care
    Omaha, NE
    $17K - $29K (Glassdoor est.)
    Easy Apply
    24d
    have strong clinical assessment and critical thinking skills necessary to provide utilization review/discharge planning services appropriate to patients…Uses personal judgment within broad guidelines to initiate review of inappropriate utilization by physicians and follows-through to resolution (e.g…
  • Oriana House, Inc. Logo3
    LPN - FT Overnight Shift
    Marietta, OH
    $12 - $18 Per Hour(Glassdoor est.)
    Easy Apply
    4d
    Quality Assurance, Utilization Review, etc…Encourages the utilization of positive reinforcement in the treatment of clients and assures that all clients receive equitable care…
  • Orchard Hospital Logo3.6
    RN Acute Care
    Gridley, CA
    Easy Apply
    14d
    Demonstrate competency in utilization review, discharge planning and transfer process… on assigned shift and unit – review care provided with direct observation and document review; assure point of care testing (POCT) quality, acuity…
  • Outpatient Therapist
    Waterloo, IA
    Easy Apply
    5d
    You will provide comprehensive mental health assessments, and assist with the utilization review process needed to maintain funding authorizations…
  • Valley View - PRN Occupational Therapist
    Canon City, CO
    Easy Apply
    1d
    . * Participate in interdisciplinary team meetings, patient care conferences, utilization review meetings, and other meetings as required or directed…
  • Ochsner LSU Health Logo3.5
    Registered Nurse (RN) - Case Manager (Kings Hwy)
    Shreveport, LA
    $36K - $51K (Glassdoor est.)
    21d
    a patient’s hospitalization, which includes a review of the appropriate utilization of resources, balanced… of Participation as it relates to utilization review and discharge planning. …
  • RN Supervisor-(Evening Shift)
    Tuscaloosa, AL
    Easy Apply
    4d
    , infection control, and utilization review activities. …
  • RN Weekend Supervisor
    Moundville, AL
    Easy Apply
    6d
    in quality assurance, infection control, and utilization review activities Assists the Director of Nursing with management of the nursing department Current R.N…
  • Director of Nursing (DON)
    Shaker Heights, Cuyahoga, OH
    Easy Apply
    3d
    Acts as a member of inter-disciplinary team to develop acute patient care plans, case management plans and utilization review
  • Regency Hospital - Florence Logo3.2
    Case Manager - per diem
    Florence, SC
    $19K - $47K (Glassdoor est.)
    Easy Apply
    3d
    The Case Manager is responsible for utilization review and resource management, discharge planning, treatment plan management and financial management, while also completing medical record documentation…Performs verification of utilization criteria reviews
  • Life Care Center of South Hill Logo3.1
    Care Manager (Registered Nurse/RN) New Wage Scale. Sign On Bonus $5000-7500
    Puyallup, WA
    $19 - $33 Per Hour(Glassdoor est.)
    Easy Apply
    4d
    ) year of clinical experience in post acute care setting preferred Prior case management, utilization review, and discharge planning experience preferred Certified Case Manager (CCM…
  • Alliance Medical Center Logo2
    Bilingual Registered Nurse RN/LVN
    Healdsburg, CA
    Easy Apply
    6d
    provider or per protocol - Direct nursing care as required by license standards of care, participates in infection control, utilization review, and quality assessment activities and analysis as directed…
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