Physician Review/Utilization Review Physician

Overview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in...

Overview UF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...

Job SummaryAurora San Diego is seeking a skilled Utilization Review Specialist to join our team. As a Utilization Review Specialist, you will play a critical role in reviewing patient care and treatment options for both inpatient and outpatient services.Key ResponsibilitiesConduct admission reviews to ensure accurate and efficient patient care.Perform...

Job Title: Utilization Review RNJob Description As a member of the Utilization Management team, the Utilization Review RN plays a crucial role in managing care, cost, and outcomes across the continuum of patient care, including acute inpatient stays and post-acute facility stays. You will coordinate continuing care and outside services for value-based risk...

About the Role:The Clinical Utilization Specialist is responsible for conducting thorough reviews of assigned admissions, continued stays, and discharge planning to ensure compliance with established clinical criteria and regulatory requirements.Key Responsibilities:Perform admission, concurrent, continued stay, and retrospective reviews using established...

Vivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan in San Francisco. It is a hybrid position with 1-2 days per week on-site required. Collaborates with the physician, nurse case manager, social worker, and other members of the health care team to meet individualized patient outcomes. Performs concurrent, and...

Medical Review Institute of America (MRIoA) is looking for Physicians, who are licensed in Minnesota to join our industry-leading peer review panel to conduct Medical Claims Reviews and Prior Authorization Reviews.Review cases from your home or office anywhere in the USA, around your current clinical activities typically 2-5 hours per week (can be more or...

Company: Oak Street HealthTitle: Full-Time Utilization Management Physician ReviewerLocation: Remote/ TreehouseRole Description:This full-time role is responsible for provisioning accurate and timely coverage determinations for inpatient and outpatient services by applying utilization management (UM) criteria, clinical judgment, and internal policies and...

Job DescriptionJob DescriptionVivo HealthStaff is searching for a Utilization Review RN for a hybrid position for a health plan in San Francisco. It is a hybrid position with 1-2 days per week on-site required.Collaborates with the physician, nurse case manager, social worker, and other members of the health care team to meet individualized patient outcomes....

Job SummaryAs a Registered Nurse Utilization Review Specialist at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the delivery of high-quality, cost-effective patient care. Your expertise will be utilized to conduct medical necessity reviews for acute care services, utilizing evidence-based guidelines to...

Pyramid Consulting is currently looking for a dedicated Licensed Practical Nurse (LPN) to fill a Utilization Review role on a local contract basis.Position OverviewThe selected candidate will be responsible for:Specialty: Utilization ReviewDiscipline: LPNEmployment Type: Local ContractKey ResponsibilitiesThe LPN will engage in:Coordinating...

Are you interested in providing your expertise, and helping your peers in the claims review process? We are looking for Physicians, who are licensed in Minnesota, to provide guidance in the Peer Review process for other Physicians in your specialty who need your skill and knowledge.Each case takes 20-60 minutes to complete and can easily be done from...

The Utilization Review Nurse performs prospective and retrospective reviews for post-acute care services. The purpose and goal of utilization management is to assure that Wellsky’s population receives medically necessary services in the appropriate setting, with the appropriate provider, and at the appropriate level of care. This position is responsible...

Description Remote - Utilization Review RN On call/Per diem The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining...

Description Remote - Utilization Review RN On call/Per diem The Utilization Review (UR) Nurse has a strong clinical background blended with a well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining...

RN-Utilization ReviewDetails * Department: UR Review * Schedule: FT - Days * Location: Austin, TX - Remote after 4 weeks of training onsite Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental...

OverviewUF Health Leesburg Hospital has been serving the health care needs of our community for 58 years. The hospital offers advanced cardiac care including one of the largest cardiothoracic surgery programs in the state. The American College of Cardiology has recognized UF Health Leesburg Hospital for its demonstrated expertise and commitment in treating...

Job DescriptionJob DescriptionA-Line staffing is hiring a Fully Remote Concurrent Review Nurse in California!If interested APPLY NOW for IMMEDIATE consideration!!Concurrent Review Nurse Details:Location: 100% Fully Remote – must live and be licensed in state of CaliforniaSchedule: Monday-Friday 8:00am-5:00pm PSTConcurrent Review Nurse CompensationThe pay...

Description The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate...

Description The Utilization Review (UR) Nurse has a strong clinical background blended with well-developed knowledge and skills in Utilization Management (UM), medical necessity and patient status determination. This individual supports the UM program by developing and maintaining effective, efficient processes for determining the appropriate...