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Utilization Review Specialist jobs

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REGISTERED NURSE OASIS/UTILIZATION REVIEW HOME HEALTH - LEHI, UT

Taking inbound calls to review clinical assessments completed upon admission, recertification, evaluation, change of condition, and transfers. Review key OASIS data items and provide education on accurate data collection, utilizat...

CompanyImpact Healthcare Llc
AddressLehi, UT
CategoryEducation/Training
Job typeFull-Time
Date Posted a month ago See detail

Registered Nurse OASIS/Utilization Review Home Health - Lehi, UT

Impact Healthcare Llc

Lehi, UT

Taking inbound calls to review clinical assessments completed upon admission, recertification, evaluation, change of condition, and transfers. Review key OASIS data items and provide education on accurate data collection, utilizat...

a month ago seen See more...

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...

a month ago seen See more...

Nurse Case Manager/Utilization Review Nurse I

State Of Vermont

Burlington, VT

80% State paid medical premium and a dental plan at no cost for employees and their families. Work/Life balance: 11 paid holidays each year and a generous leave plan. State Paid Family and Medical Leave Insurance (FMLI). Two ways...

2 months ago seen See more...

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...

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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...

2 months ago seen See more...

Utilization Review-Case Management (Full-Time)

Aurora San Diego

San Diego, CA

$66,560 - $124,800 a year

Pay Range: $32/hr. to $60/hr. Admissions: Conduct admission reviews. Concurrent/Stay Reviews: Conduct concurrent and extended stay reviews. Payment Appeals: Prepare and submit appeals to third party payers. Recordkeeping: Maintain...

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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...

2 months ago seen See more...

Registered Nurse / RN Utilization Review

Lovelace Medical Center

Albuquerque, NM

$64.1K - $81.1K a year

Medical, vision, dental health insurance, health savings account / flexible spending, competitive pay, paid time off, 401k retirement plan with company match, employee assistance program and more. Lovelace Health System includes s...

2 months ago seen See more...

Utilization Review Nurse

American Health Plans Llc

Franklin, TN

$57.9K - $73.4K a year

Affordable Medical/Dental/Vision insurance options. Generous paid time-off program and paid holidays for full time staff. TeleDoc 24/7/365 access to doctors. Optional short- and long-term disability plans. Employee Assistance Plan...

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Registered Nurse Utilization Review -- Utilization Review -- General Hospital

Camc Health System

Charleston, WV

$61.3K - $77.6K a year

Efficiently coordinate patient needs to assure high quality patient care, reduce length of stay and resource utilization and ensure reimbursement drawing on a broad clinical and systems management knowledge base.Responsibilities...

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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...

2 months ago seen See more...

Utilization Review RN

A-Line Staffing Solutions

Harrisburg, PA

Review, understand and relate pertinent Departmental, State and Federal policies, licensure requirements, and regulations to ensure compliance by Medical Assistance (MA)/OLTL providers. Participate in the development of new and/or...

2 months ago seen See more...

Manager - Case Management & Utilization Review, Jay Hospital

Baptist Health Care Corporation

Jay, FL

3 years nursing experience in the clinical setting Required. 1 year Case Management or Utilization Review experience Preferred. Excellent verbal and written communication skills required. Understands health care finance relative t...

2 months ago seen See more...

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...

2 months ago seen See more...

Utilization Review Nurse

Theoria Medical

Novi, MI

$80,000 - $85,000 a year

Monday-Friday 8am to 5pm. Remote. This is a full-time, remote position. Utilization management. Clinical quality management. Care coordination/Case management. ACO Alignment activities. Review patient medical records and documenta...

2 months ago seen See more...

Health Service Assistant - Utilization Review

Presbyterian Healthcare Services

Albuquerque, NM

Up to $23.99 an hour

Full Time - Exempt: No The job is based at Presbyterian Hospital Work hours: 10 Hour Days Benefits: We offer a wide range of benefits including medical, wellness programs, vision, dental, paid time off, retirement, and more for FT...

2 months ago seen See more...

LVN DSD Utilization Review, Skilled Nursing

Community Medical Centers Of Fresno, Ca

Fresno, CA

Join a Forbes Top 10 CA Employer! Direct impact on quality patient care. Time and a half after 8 hrs + weekend and night differential (call pay for procedural areas). Free Continuing Education and certification including BLS, ACLS...

2 months ago seen See more...

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...

2 months ago seen See more...

Utilization Review Case Manager CMC

Utmb Health

Friendswood, TX

Demonstrates thorough knowledge of Inter Qual Criteria, CMC Specialty Referral Guidelines and Protocols used to determine status for inpatient admission or observation in Community Hospitals and UTMB-TDCJ Hospital. Performs utiliz...

2 months ago seen See more...

Utilization Review RN, Lead - $4,000 Sign-On Bonus

Island Health

Anacortes, WA

Reviews medical records for determination and documentation of medical necessity for inpatient and/or observations status utilizing established criteria and methods.. Identifies issues and variations in utilization and escalates t...

2 months ago seen See more...

Utilization Review RN

Coxhealth

Springfield, MO

5x Modern Healthcare Best Places to work. America's Greatest Workplaces 2023 - Newsweek. Best Employers for New Grads 2023- Forbes. Greatest Workplace for Women 2023 - Newsweek. Robust, fully customizable benefits package includin...

2 months ago seen See more...

LVN - Inpatient Utilization Review Nurse - SRS Copley - Days - FT

Sharp Healthcare

San Diego, CA

$74.8K - $94.7K a year

3 Years experience in the acute patient care, Home Health and/or SNF setting. 2 Years Utilization/Case Management experience, preferably in a Managed Care setting. California Licensed Vocational Nurse (LVN) - CA Board of Vocationa...

2 months ago seen See more...

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...

2 months ago seen See more...

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...

2 months ago seen See more...

Utilization Review Clinician - Behavioral Health

Centene Corporation

Atlanta, GA

Evaluates member's treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate. Performs prior authorization reviews related to mental health an...

2 months ago seen See more...

Utilization Review Nurse (40 Hour)

State Of Connecticut

Hartford, CT

Work Unit: Inpatient Unit. Work Schedule: Monday - Friday. Work Hours: Full-time, 40 Hours per week. Work Shift: First shift, 8:00 a.m. - 4:30 p.m. Location: 500 Vine St, Hartford, CT. A Platinum Healthcare Plan, the nation's best...

2 months ago seen See more...

Utilization Review RN - Utilization Management Dept OCGMC

Kpc Global Medical Centers Inc.

Santa Ana, CA

$50 - $85 an hour

Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management and Treatment Team meetings Serves as on-going educator to all departments. Responsible for reviewing patient charts in...

2 months ago seen See more...

Registered Nurse Utilization Review

Edward-Elmhurst Health

Naperville, IL

$69.2K - $87.6K a year

Position: RN Utilization Review Location: Edward Hospital 801 S Washington St Naperville, IL. Full Time; 40 hour week Hours: Monday-Friday 8:00am- 4:30 pm Rotating weekends. Will help out at Elmhurst Hospital and Corp Center Offic...

2 months ago seen See more...

Utilization Review Nurse - Case Management

Kern Medical

Bakersfield, CA

$41.32 - $65.10 an hour

New Hire Bonus: $6,000.00. New Hire Premium: +6% of base rate of pay, matched up to 6% if contributed to Deferred Compensation Plan. Shift Differential Pay: 10% of base pay for hours worked from 7:00 PM to 7:30 AM, with two (2) ho...

2 months ago seen See more...

UTILIZATION REVIEW SPECIALST (PRN)

Rockford Center

Newark, DE

$71.8K - $91K a year

Completes pre-certs and concurrent reviews as assigned, on appropriate day and by the specified time. Completes write-ups on new admissions and step-downs/step-ups as assigned, along with the Change Level of Care form when appli...

2 months ago seen See more...

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What are the top cities open Utilization Review Specialist jobs?

There are open Utilization Review Specialist jobs in several cities including San Jose, Melbourne, Columbia, Skokie, Englewood, Traverse City, Falmouth, Oak Ridge, Reading, Midvale, Williamsburg, Salt Lake City, Las Cruces, Pittsburgh, Santa Ana,

What companies are hiring for Utilization Review Specialist jobs?

The top companies hiring now for Utilization Review Specialist jobs are Advanced Recovery Systems, Austin Treatment Centers, Brighton Recovery Center, Catholic Charities - Diocese of Trenton, Catholic Charities, Diocese of Trenton, Circles of Care, Inc., Denver Springs, Ensemble Health Partners, Exact Billing Solutions, Gosnold, Wecare Pa, White Deer Run,

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