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Utilization review Jobs

9,157 Jobs

  • 2.2
    River City Medical Group – Sacramento, CA
    NEW
    direction and oversight of the Supervisor of Utilization Management, the UtilizationReview Nurse is responsible and accountable for… facility as well as outpatient services as delegated. The UtilizationReview Nurse coordinates all systems/services needed for an organized…
  • 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…
  • 2.2
    River City Medical Group – Sacramento, CA
    9 days ago 9d
    direction and oversight of the Supervisor of Utilization Management, the UtilizationReview Nurse is responsible and accountable for… facility as well as outpatient services as delegated. The UtilizationReview Nurse coordinates all systems/services needed for an…
  • 3.2
    Centura Health – Littleton, CO
    $58k-$73k(Glassdoor est.)
    NEW
    reversals.*  Performs utilizationreview in accordance with UM Plan to include concurrent/retro reviews and verify admission/bed… care through discussions with treatment team/review of documentation. *  Utilizes tools such as guidelines, criteria, or clinical…
  • 3.3
    AmeriHealth Caritas – Harrisburg, PA
    10 days ago 10d
    Supervisor of Utilization Management, the Clinical Care Reviewer is responsible for completing medical necessity reviews using AHC… Clinical Care ReviewerUtilization Management Location Harrisburg, PA ID** 12959 Apply Now…
  • 4.2
    White Glove Placement – Syracuse, NY
    EASY APPLY
    9 days ago 9d
    RN Case Manager / UtilizationReview White Glove Placement Inc is a nurse staffing agency. We staff many major hospitals,… currently hiring RN Registered Nurses for Case Manager / UtilizationReview position at one of our client teaching hospitals Syracuse…
  • 3.1
    HonorHealth – Scottsdale, AZ
    $62k-$80k(Glassdoor est.)
    HOT
    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…
  • 3.1
    Quantum Health – Columbus, OH
    9 days ago 9d
    Job Title: UtilizationReview Nurse Working Group: Clinical Operations Reports to: Pod Manager Description: The utilization… request within the designated time frames indicated. The utilizationreview nurse also functions as a clinical resource to other staff…
  • 3.2
    Presbyterian Healthcare Services – Albuquerque, NM
    NEW
    documentation in the medical record. Will be responsible to review physician documentation on a daily basis, keep track of patient… coverage issues and a team player in consultation with other reviewers and HIM coders. Excellent communication skills are essential…
  • 3.3
    Memorial Hospital of Jacksonville – Jacksonville, FL
    $50k-$66k(Glassdoor est.)
    4 days ago 4d
    planning for individuals, couples, families, and groups. Utilizationreview for the insurance companies. The RN Case Manager also…
  • 3.3
    Rideout Health – Camptonville, CA
    11 days ago 11d
    RN) - Case Management/UtilizationReview Registered Nurse (RN) - Case Management/UtilizationReview Department: Case Management… 120 mile radius of Rideout Hospital DEFINITION: Utilizationreview nurses work with physicians, medical staff, case management…
  • 4.0
    Newport Academy – Corona del Mar, CA
    EASY APPLY
    We're Hiring!
    seeking a UtilizationReview Specialist. Under the supervision of the Director of UtilizationReview, the UtilizationReview Specialist… and families. The UtilizationReview Specialist is responsible for organizing and coordinating UtilizationReview activities within…
  • 4.5
    Northeastern Vermont Regional Hospital – Saint Johnsbury, VT
    NEW
    fortunate." Employee review on glassdoor.com Responsibilities: · Responsibilities include utilizationreview, medical social… 401K Retirement Plan with employer contribution as well as utilize free membership to select local gyms. · Community: Be part…
  • 3.9
    OneStaff Medical – Fort Myers, FL
    $56k-$77k(Glassdoor est.)
    Today 8hr
  • 3.6
    Florida Hospital Memorial Medical Center – Orange City, FL
    16 days ago 16d
    The Registered Nurse RN UtilizationReview Case Manager will provide quality utilization case reviews and monitor hospital resource… procedures/tests. The Registered Nurse RN UtilizationReview Case Manager Utilizes professional nursing knowledge to ensure that…
  • 3.9
    Advanced Resources – Chicago, IL
    We're Hiring!
    level of care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case… Conduct discharge planning Educate providers on utilization and medical management processes Provide clinical…
  • 3.7
    Scripps Health – La Jolla, CA
    $50k-$76k(Glassdoor est.)
    We're Hiring!
    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…
  • 4.3
    Children's Home Healthcare – Boerne, TX
    EASY APPLY
    $53k-$68k(Glassdoor est.)
    NEW
    Health services from insurance company. Attend quarterly UtilizationReview meetings as designated by the Director of Professional… basis per company policy. Review/approve plan of care and all related documents prior to physician review/signing. Provide patient…
  • 3.2
    Morton Plant Hospital – Clearwater, FL
    12 days ago 12d
    services. The Senior UtilizationReview Specialist is responsible for the oversight of the utilizationReview Specialists. Perform… The Senior UtilizationReview Specialist functions as the primary liaison between the funding agents and all other related parties…
  • 4.0
    BHR – Oakland, CA
    NEW
    The UtilizationReview Specialist is responsible for reviewing of assigned admissions, continued stays, utilization practices… Job Description About BHR UtilizationReview Specialist Becton Healthcare Resources, Inc. (BHR) is a leader and one of…
  • 5.0
    White Sands Treatment Center – Plant City, FL
    EASY APPLY
    HOT
    needed. In addition, candidate must have experience with utilizationreview. Principle Duties & Responsibilities: Gather comprehensive… program rules and regulations in a firm but fair manner UtilizationReview (UR) experience to include: Comprehensive knowledge…
  • 5.0
    Cameron Craig Group – Las Vegas, NV
    $161k-$246k(Glassdoor est.)
    11 days ago 11d
    addition to doing utilization management activities, but also medical review activities pertaining to utilizationreview, quality assurance… opportunity for someone who is interested in working a UtilizationReview role in the Las Vegas region. It is required you have…
  • 3.8
    BayCare Health System – Tampa, FL
    12 days ago 12d
    services. The Senior UtilizationReview Specialist is responsible for the oversight of the utilizationReview Specialists. Perform… The Senior UtilizationReview Specialist functions as the primary liaison between the funding agents and all other related parties…
  • 4.3
    Children's Home Healthcare – Albuquerque, NM
    EASY APPLY
    $55k-$71k(Glassdoor est.)
    NEW
    Health services from insurance company. Attend quarterly UtilizationReview meetings as designated by the Director of Professional… basis per company policy. Review/approve plan of care and all related documents prior to physician review/signing. Provide patient…
  • 3.2
    Medical Center of Trinity – Trinity, FL
    $48k-$63k(Glassdoor est.)
    11 days ago 11d
    our business, it's our heartfelt passion. The UtilizationReview Nurse will be responsible for ensuring all admissions…
  • Therapy Employee Associated Management, LLC – Fort Lauderdale, FL
    14 days ago 14d
    experienced UtilizationReview Specialist to join our team in Ft. Lauderdale, Florida! The UtilizationReview Specialist (UR… efficient manner Reviews over / under utilization of facility resources Develops UR statistics and reports for review by the Executive…
  • 2.9
    CleanSlate Centers – United States
    1 days ago 1d
    treatment team members and case management Collaborate with utilizationreview team to provide necessary clinical information for insurance…
  • 3.5
    ABH – Middletown, CT
    8 days ago 8d
    UtilizationReview Description: POSITION SUMMARY: The UtilizationReview Support position performs various clinical and…
  • 3.9
    Favorite Healthcare Staffing – Denver, CO
    EASY APPLY
    We're Hiring!
    professionals across America! Title: Registered Nurse, UtilizationReview Job Type: Temp to Perm Specialty: Managed Care Administration… on experience Facility in Denver seeks a full-time UtilizationReview RN for a temp to hire contract working in Managed Care…
  • 2.9
    CleanSlate Centers – United States
    NEW
    treatment team members and case management Collaborate with utilizationreview team to provide necessary clinical information for insurance…
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