Utilization Review Specialist Jobs | Glassdoor
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Utilization Review Specialist Jobs

7,848 Jobs

  • 3.4
    Chrysalis Health – Altoona, FL
    17 days ago 17d
    initial, concurrent, discharge and appeal reviews. The UtilizationReviewSpecialist will facilitate patients through the continuum… Overview The UtilizationReviewSpecialist is responsible for a variety of activities in support of the Billing Department…
  • 3.7
    Florida Hospital – Orlando, FL
    HOT
    clinical staff, psychiatric utilization care managers and payer mix. The UtilizationReviewSpecialist provides comprehensive knowledge… Florida Hospital Orlando seeks to hire a UtilizationReviewSpecialist in the Center for Behavioral Health who will embrace…
  • 2.7
    Collateral Management LLC – Fort Lauderdale, FL
    NEW
    energetic, ambitious and solution oriented Reviewer, Auditor, Processor, Analyst Specialist who wants to develop their career and work… needed. Job Description: The documentation review will include a review of the entire file to determine whether all items…
  • 5.0
    The Araz Group – Bloomington, MN
    NEW
    a privately held and operated company since 1982. HealthEZ utilizes state-of-the-art benefit administration tools that offer innovative…
  • 3.2
    MemorialCare Health System – Fountain Valley, CA
    4 days ago 4d
    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…
  • 3.4
    Presbyterian Healthcare Services – Albuquerque, NM
    9 days ago 9d
    expertise performing utilization management functions (i.e., prior authorization, medical claims review to include prospective… appropriate setting. Utilizes clinical skills to to coordinate, document and communicate all aspects of the utilization/benefit management…
  • 3.7
    Lexington Medical Center – West Columbia, SC
    NEW
    Requirements: BS degree in nursing Experience in utilizationreview or case management SDL2017… Utilization Management Part-Time Weekend 7pm to 7am/Saturday and Sunday nights Registered Nurse Basic…
  • 5.0
    Community Mental Health for Central Michigan – Mount Pleasant, MI
    19 days ago 19d
    Job Description UtilizationReviewSpecialist The UtilizationReviewSpecialist is responsible for authorizing and monitoring… Completes clinical case reviews and performs retrospective, concurrent, and prospective Utilizationreviews. Demonstrates significant…
  • 4.6
    Residential Home Health and Residential Hospice – Downers Grove, IL
    HOT
    Episode ReviewSpecialist Residential Home Health is a national leader of home care in both Michigan and Illinois and is… careers/ Residential is seeking a full-time Episode ReviewSpecialist for our office located in Downers Grove, Illinois.…
  • 3.7
    Memorial Hermann Healthcare – Houston, TX
    5 days ago 5d
    UtilizationReview SpecialistSouthwest Hospital Job Description Position responsible for the clinical appropriateness (utilization… . Utilizationreviews may extend through continued stay and involve discharge planning activities under the direction of an RN…
  • 3.9
    Valley Behavioral Health – Fort Myers, FL
    5 days ago 5d
    UtilizationReviewSpecialist Facility: Park Royal Hospital Company: Fort Myers, FL Park Royal Behavioral Health Services… hospital and system have an immediate opening for a UtilizationReviewSpecialist. We offer a comprehensive salary and benefit package…
  • 3.1
    Trinity Health – Ann Arbor, MI
    NEW
    Department: AA102_65501 UtilizationReview Expected Weekly Hours: 0 Shift: Position Purpose: Job Description…
  • 3.4
    MultiCare Health System – Tacoma, WA
    $65k-$83k(Glassdoor est.)
    10 days ago 10d
    Position Summary: The UtilizationReview (UR) Specialist is responsible for concurrent utilization management activities to… to a defined patient population. The UtilizationReview (UR) Specialist is a link between the patient, health care team, organization…
  • 3.7
    Memorial Hermann Baptist Hospital – Houston, TX
    5 days ago 5d
    UtilizationReview SpecialistSouthwest HospitalJob DescriptionPosition responsible for the clinical appropriateness (utilization… Prefer 2-3 years experience in Quality Assurance or UtilizationReview or Discharge Planning Demonstrates commitment to the…
  • 3.4
    Brattleboro Retreat – Brattleboro, VT
    4 days ago 4d
    Conducts concurrent chart and retrospective review as requested by the Director of Utilization Management and Contracting. Communicates… required for ongoing review, review schedule, denial of stay, and, coordination of Physician to Physician review, and/or appeals.…
  • 3.1
    McLaren Health Care – Mount Clemens, MI
    4 days ago 4d
    Management, the UtilizationReviewSpecialist is responsible for facilitating and coordinating UtilizationReview activities in… coordinating and evaluating information for the overall pre-utilizationreview, authorization, status changes, commercial payer appeal…
  • 4.0
    BHR – Oakland, CA
    21 days ago 21d
    service organization. UR Specialist The UtilizationReviewSpecialist is responsible for reviewing of assigned admissions, continued… Job Description About BHR UtilizationReviewSpecialist Becton Healthcare Resources, Inc. (BHR) is a leader and one of…
  • 3.4
    Rochester Regional Health – Newark, NY
    $51k-$64k(Glassdoor est.)
    NEW
    SUMMARY The UtilizationReviewSpecialist actively participates in the utilization management of patients and evaluating hospital… hospital admissions with the use of utilization screening criteria and CMS Guidelines. RN's actively participates in maximizing…
  • 3.1
    INFINITY BEHAVIORAL HEALTH SERVICES – Fort Lauderdale, FL
    EASY APPLY
    NEW
    regulatory compliance. INFINITY is now seeking UtilizationReviewSpecialists to join our team. INFINITY offers competitive… Medicine) criteria to review clinical information with insurance companies Performs peer to peer reviews and appeals with insurance…
  • 3.4
    Martin Memorial Medical Center – United States
    12 days ago 12d
    The UtilizationReviewSpecialist is responsible for concurrent and retrospective medical record review activities on all inpatients… in utilization or other applicable certification attained within 24 months of accepting the position as UtilizationReview Specialist…
  • 2.9
    Decatur Memorial Hospital – Decatur, IL
    5 days ago 5d
    position reviews services to patients of all ages to ensure appropriate status of admission, length of stay and utilization of criteria… and focused reviews using InterQual criteria and CMS regulations. Maintains appropriate documentation of reviews. Refers medical…
  • 4.3
    Springstone – Avondale, AZ
    NEW
    necessary treatment. As a UtilizationReviewSpecialist, you will accurately and timely complete utilizationreview activities. Members… UtilizationReviewSpecialist - PRN Copper Springs is a 72-bed behavioral hospital located in Phoenix, AZ. The hospital…
  • 2.8
    Universal Health Services – Fremont, CA
    NEW
    POSITION SUMMARY The Lead UtilizationReviewSpecialist is responsible for leading the UtilizationReview Department in the facilitation… adults. We are seeking to fill a full-time Lead UtilizationReviewSpecialist position with benefits. Fremont Hospital is part…
  • 3.7
    HealthPartners – Bloomington, MN
    $62k-$77k(Glassdoor est.)
    9 days ago 9d
    opportunity for a UtilizationReviewSpecialist (RN). This position will be: Responsible for prospective, concurrent review and retrospective… retrospective review authorizations and ongoing management for outpatient/inpatient medical, home health care and skilled nursing…
  • 3.1
    Acadia Healthcare – Fort Myers, FL
    23 days ago 23d
    UtilizationReviewSpecialist Facility: Park Royal Hospital Company: Fort Myers, FL Park Royal Behavioral Health Services… hospital and system have an immediate opening for a UtilizationReviewSpecialist. We offer a comprehensive salary and benefit package…
  • 2.8
    Universal Health Services – King of Prussia, PA
    NEW
    experience. Case Management experience, and/or UtilizationReview, Utilization Management skills in a clinical setting required… criteria set. Applies best practice and standards in the UtilizationReview Entry (URE) application of Midas, and as needed within…
  • 4.3
    Springstone – West Chester, OH
    6 days ago 6d
    necessary treatment. As a UtilizationReviewSpecialist, you will accurately and timely complete utilizationreview activities. Members… patients recommend treatment at Beckett Springs* The UtilizationReview department plays an essential role in helping fulfill…
  • 3.2
    CaroMont – Gastonia, NC
    26 days ago 26d
    attending physicians regarding utilization issues. Collaborates with discharge planning specialist and other disciplines.… physicians regarding utilization issues. Assign patients that have had insurance verified to the UR Specialists on Provider Link.…
  • 3.1
    Morton Plant Hospital – Clearwater, FL
    Today 2hr
    . The Senior UtilizationReviewSpecialist is responsible for the oversight of the utilizationReviewSpecialists. Perform other… The Senior UtilizationReviewSpecialist functions as the primary liaison between the funding agents and all other related parties…
  • 3.1
    Horizon Health Services – United States
    16 days ago 16d
    family. We are currently looking for a full time UtilizationReviewSpecialist in Buffalo. This position is Monday- Friday only… Medicaid and Public Assistance Record and complete concurrent reviews and set up appeals as needed. Work with A/R staff to address…
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