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Utilization Specialist jobs

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UTILIZATION MANAGEMENT & REVIEW SPECIALIST

Serve as point of contact for client operational staff members impacted by UM/UR Processes. Track and monitor solutions implemented for clients and operational staff. Identifies system needs to support short and long term product...

CompanyMed-Metrix
AddressParsippany, NJ
CategoryHuman Resources
Job typeFull-Time
Date Posted 2 weeks ago See detail

Utilization Management & Review Specialist

Med-Metrix

Parsippany, NJ

Serve as point of contact for client operational staff members impacted by UM/UR Processes. Track and monitor solutions implemented for clients and operational staff. Identifies system needs to support short and long term product...

2 weeks ago seen See more...

MC SENIOR UTILIZATION MANAGEMENT SPECIALIST I

University Of Maryland Medical System

Baltimore, MD

Under general supervision, provides utilization review and denials management for an assigned patient case load. This role utilizes nationally recognized care guidelines/criteria to assess the patients need for outpatient or inpa...

3 weeks ago seen See more...

Laboratory Utilization Management and Process Improvement Specialist

Labcorp

Portland, OR

$83K - $105K a year

Uses knowledge of Medical Laboratory Science in combination with IT skills to support customers in working through application to produce meaningful reports and data sets. Demonstrates knowledge of laboratory processes from the pr...

4 weeks ago seen See more...

Resource Utilization/Classification Tech - HIM Reimbursement Specialist - PT - Remote

Mercyone

Dubuque, IA

$47.6K - $60.3K a year

Wellness programs Education reimbursement Personalized health insurance plans including dental and vision Paid time off Long- and short-term leave Retirement planning Life insurance coverage Demonstrates specific customer focused...

a month ago seen See more...

Utilization Review Specialist

Ambrosia Treatment Centers

Lorida, FL

From $69,900 a year

401(k). Dental insurance. Disability insurance. Health insurance. Life insurance. Paid time off. Vision insurance. 8 hour shift. Monday to Friday. Bachelor's (Preferred). Utilization review: 2 years (Required). Florida (Required)....

a month ago seen See more...

RN SPECIALIST RN UTILIZATION

Honorhealth

Scottsdale, AZ

Reviews clinical documentation and facilitates modifications (as needed) to ensure that documentation accurately reflects the level of service rendered and severity of illness (in compliance with government and other regulations)...

a month ago seen See more...

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...

a month ago seen See more...

Staff Development Specialist in Utilization Review

Reportprep, Inc

Palestine, TX

$45,000 - $75,000 a year

401(k) matching. Dental insurance. Disability insurance. Employee assistance program. Flexible spending account. Health insurance. Health savings account. Life insurance. Paid sick time. Paid time off. Vision insurance. Monday to...

a month ago seen See more...

Specialist, Legal Staffing & Utilization

Kobre & Kim Llp

New York, NY

$85,000 - $125,000 a year

Actively assess and analyze attorney workloads, experience, interests, feedback, and availability to effectively staff them on matters Maintain up-to-date knowledge of firm legal products and how they overlap with attorney experti...

a month ago seen See more...

Utilization Review Specialist (remote)

Coronis Health

El Paso, TX

$48,000 - $65,000 a year

Act as agency liaison with insurance and managed care companies for authorization of treatment costs, representing company in a positive manner in the professional Participate in staff meetings as needed Clear communication with s...

a month ago seen See more...

Utilization Management Specialist

Group1001

Park Ridge, IL

Performs prospective, initial, concurrent, and retrospective reviews for all requested services to include but not limited to the following: inpatient admissions, concurrent reviews, discharges, durable medical equipment (DME), Pa...

a month ago seen See more...

Utilization Review Specialist

Affinity Recovery

Newport Beach, CA

$65,000 - $75,000 a year

Clinical Record Review: Thoroughly review mental health and substance abuse clinical records. Utilization Determination: Evaluate treatment plans and services for compliance and necessity. Collaboration: Work closely with clinical...

a month ago seen See more...

Supervisory Acquisition & Utilization Specialist

York State Department Of Labor

New York, NY

Responsibilities Duties: The Supervisory AcquisitionUtilization Specialist renders expert contract pre-award and post award expertise to all Administrative and Clinical Service lines within the VA Healthcare System (HCS) and supp...

a month ago seen See more...

Utilization Review (UR) Specialist - Addiction Treatment Program

Renewal Health Group

Los Angeles, CA

Medical, dental, vision, short-term disability, and life insurance. Reimbursement for licensing fees. Education assistance. Employee referral bonus. Healthcare Flexible spending account with $250 company contribution for Full time...

a month ago seen See more...

Physician Utilization Review Specialist

Hackensack Meridian Health

Hackensack, NJ

The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and HackensackUMC. These includ...

a month ago seen See more...

Utilization Management Specialist

Allmed Staffing Inc

Everett, WA

Initiate Referral Authorizations. Acquires and maintain a working knowledge of contracted health plans agreements and related insurance products. Gathers information from relevant sources for processing referrals and authorization...

2 months ago seen See more...

Utilization Review Specialist

Delta Specialty Hospital

Memphis, TN

$46.7K - $59.2K a year

Act as liaison between managed care organizations and the facility professional clinical staff. Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coor...

2 months ago seen See more...

Utilization Review Specialist

Pacific Grove Hospital

Riverside, CA

$60.6K - $76.7K a year

Competitive Salary. Paid Time Off. Paid Holidays (8 Total). Medical, Dental, & Vision Insurance. FSA & HSA Plans. Long-Term & Short-Term Disability. Company Paid Life Insurance. Supplemental Life Insurance. Employee Assistance Pro...

2 months ago seen See more...

UR (Utilization Review) Specialist

Sunshine Behavioral Health

Denver, CO

$58,000 - $60,000 a year

Conducts timely; Precertification, Concurrent and Discharge reviews (Peer reviews and eligibility checks as necessary) as well as retro reviews and appeals as needed. Organizes and communicates information necessary to complete da...

2 months ago seen See more...

Utilization Review Specialist

Tuerk House

Baltimore, MD

$49.3K - $62.4K a year

Maintains documentation of clinical reviews in Utilization Management Portal (OPTUM). Sends thorough reviews to OPTUM and Private insurance as appropriate. Coordinates peer review and notifications, per policy. Collaborates with...

2 months ago seen See more...

Senior Associate, Information Specialist – Content Optimization & Utilization

Pfizer

Cambridge, MA

$78,000 - $130,000 a year

Support optimization of SIC licenses by monitoring/analyzing/reporting usage metrics/trends to enable learning opportunities and inform renewal decisions. Partner with R&D groups on select initiatives involving eResource and eCont...

2 months ago seen See more...

Utilization Review Specialist

Coastal Media Group

Boca Raton, FL

$55,000 - $75,000 a year

Ability to be aggressive in advocating on behalf of our facilities to insurance carries. Ability to communicate effectively with clinical team to understand treatment needs of patients. Understanding of their role in a multi-disci...

2 months ago seen See more...

Specialist - Utilization Review - Full Time, Days (Hollywood)

Prospect Medical Holdings

California, United States

From $23.20 an hour

Interfaces with all payors and providers requesting authorizations, medical records, and other specific information. Completes payor and provider request for missing or additional documentation. Logs all authorization requests to...

2 months ago seen See more...

Utilization Management Specialist II

Pinnacle Treatment Centers

Cambridge City, IN

$42.7K - $54.1K a year

working collaboratively with the treatment team and health plans to obtain authorization for treatment. Masters Degree in Social Work, Psychology, Counseling, or related Human Services field is required. Licensed Clinical Social...

2 months ago seen See more...

Utilization Management Nurse Specialist, FT Days

Pih Health

Whittier, CA

Current knowledge of Managed Care and Health Plan Division of Financial Responsibilities (DOFR). Ability to apply appropriate UM criteria. Excellent communication skills. Strong organizational capabilities. Attention to detail is...

2 months ago seen See more...

Utilization Management Specialist

Ocd Anxiety Centers

South Jordan, UT

A competitive base salary starting at $18.00 per hour, depending on experience. 401k match. Core benefits: medical/dental/vision, with the company contribution to medical benefits for employee. Company-paid employee life insurance...

2 months ago seen See more...

Utilization Review Specialist

Department Of Behavioral Healt

Washington, DC

$89,958 - $115,104 a year

Criminal background check;. Traffic record check (as applicable);. Consumer credit check (as applicable);. Reasonable suspicion drug and alcohol test; and. Post-accident or incident drug and alcohol test....

2 months ago seen See more...

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What are the top cities open Utilization Specialist jobs?

There are open Utilization Specialist jobs in several cities including San Antonio, North Liberty, Danville, Oklahoma City, Anchorage, Dallas, Washington, Alexandria, Las Vegas, Springfield, Harlingen, Tucson, Johnson City, Gainesville, Bell Gardens,

What companies are hiring for Utilization Specialist jobs?

The top companies hiring now for Utilization Specialist jobs are Montrose Behavioral Health Hospital, Summit BHC, Veterans Health Administration,

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