Nurse Utilization Review jobs in Kansas

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CLINICAL/UTILIZATION REVIEW NURSE

Manages complex and robust queue according to Aspirion and client needs. Queue size varies weekly. Reviews insurance denials, including but not limited to, medical necessity denials, patient status denials (i.e., Inpatient vs. Out...

CompanyAspirion Health Resources Llc
AddressRemote
CategoryEducation/Training
SalaryFrom $68,000 a year
Date Posted 2 months ago See detail

Clinical/Utilization Review Nurse

Aspirion Health Resources Llc

Remote

From $68,000 a year

Manages complex and robust queue according to Aspirion and client needs. Queue size varies weekly. Reviews insurance denials, including but not limited to, medical necessity denials, patient status denials (i.e., Inpatient vs. Out...

Utilization Review Nurse (RN)

Managed Resources, Inc

Remote

$38 - $42 an hour

401(k). 401(k) matching. Dental insurance. Disability insurance. Employee assistance program. Flexible spending account. Health insurance. Life insurance. Paid time off. Referral program. Vision insurance. Pet Insurance. Monthly I...

Utilization Review Nurse- PRN

Netsmart Technologies

Remote

$77.6K - $98.3K a year

Review electronic medical records of emergency department admissions and screen for medical necessity, using InterQual or MCG criteria. Participate in telephonic discussions with emergency department physicians relative to documen...

Utilization Review Specialist

Goat Solutions, Llc

Florida, United States

$55,000 - $65,000 a year

Minimum of 1 year experience in substance abuse or behavioral health Utilization Review. Experience in EMRs. Proficient with computer programs (Google Drive, Word, etc). Ability to manage an active caseload for clients at the deto...

Utilization Review Specialist

Congress Billing

Remote

$60,000 - $70,000 a year

Master's degree from an accredited college or university in social work, mental health, nursing, or related degree Required. Knowledge of behavioral health systems and Utilization Management required. Two years of UR experience in...

Utilization Review (UR) Specialist

Spectrum Billing Solutions

Remote

$53.5K - $67.8K a year

Review patient admission and clinical information to ensure medical necessity and compliance of Utilization Review guidelines. Obtain initial and continuing authorization for treatment services. Manage authorization denials includ...

RN Utilization Review Ananlyst- 31501224

Allmed Staffing Inc

Maryland, United States

Ability to sit at a desk 50% of the time and utilize the computer, telephone, and other office equipment, throughout the entire work day; walking and standing ? Time-management: Ability to effectively manage one's time and resourc...

Utilization Review Coordinator Lead

Umpqua Health

Remote

$61.3K - $77.6K a year

Assesses services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and internal and external guidelines. Leads also provide oversight, monitoring and training of thes...

Utilization Review RN

Ust

United States

$60,000 - $90,000 a year

Review, research and authorize requests for authorization of elective, direct, ancillary, urgent, emergency, etc. services. Contact appropriate medical and support personnel to identify and recommend alternative treatment, service...

Behavioral Health Care Advocate - Utilization Review (Outpatient) - Remote

Optum

Minnesota, United States

$58,300 - $114,300 a year

Focus on outpatient Commercial, Medicaid and Medicare Behavioral Health services. Conducting outpatient reviews to determine appropriate care. Assessing if member care meets coverage guidelines. Shaping member treatment in partner...

Utilization Review Specialist

Charlie Health

Remote

$61K - $77.2K a year

Oversees all functions of a virtual IOP caseload. Completes peer reviews on cases with insurance. Collaborates at a high level to problem solve on complex cases with Manager. Completes pre-certs and continued stay authorizations f...

Utilization Review Author

R1 Rcm, Inc.

Remote

$24.00 - $41.68 an hour

Perform initial admission and continued stay reviews utilizing InterQual and MCG using evidenced-based criteria to identify and support the appropriate level of care Abstract data from a variety of medical records to ensure accura...

RN Utilization Review- Allegheny Health Network

Highmark Health

Remote - Pennsylvania, United States

Obtains or ensures acquisition of appropriate pre-certifications/authorizations from third party payers and placement to appropriate level of care prior to hospitalization utilizing medical necessity criteria and third party payer...

Associate Director, Utilization Management Nursing - VA Medicaid

Humana

Virginia, United States

$102,200 - $128,000 a year

Serves as a liaison between Humana and the Commonwealth regarding prior authorization reviews, prepayment retrospective reviews, and any additional Utilization Management functions. Coordinates with the Clinical Leadership team to...

Utilization Management Reviewer I

Crawford & Company

United States

$75.3K - $95.3K a year

Uses clinical RN or RPT training and knowledge to render authorization decisions of medical necessity of requested medical treatment. Analyzes medical information and applies clinical knowledge and established criterion to facilit...

Behavioral Health Utilization Management Nurse

United Claim Solutions Llc

Remote

$60.5K - $76.6K a year

Conduct timely reviews of UM activities, including prospective, concurrent, and retrospective reviews and apply to summary plan documents or other resources related to the request. Collaborate with appropriate parties to apply the...