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Utilization Review Specialist
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Utilization Review Specialist
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Utilization Review Coordinator
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Utilization Insurance Specialist
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Utilization Review Coordinator
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RN Utilization Review
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Utilization Review Nurse
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New York, New York, United States VNS Health Full timeAbout the JobVNS Health is seeking a skilled Nurse Care Coordinator to lead interdepartmental quality improvement activities, ensuring optimal patient care and compliance with regulatory requirements.Key ResponsibilitiesConduct Clinical Assessments: Perform medication reconciliations, post-discharge transitions of care assessment, and follow-up post...
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Utilization Review Nurse
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Nurse Utilization Review Specialist
49 minutes ago
New York, New York, United States VNS Health Full timeJob Title: Registered Nurse - Utilization ReviewVNS Health is seeking a skilled Registered Nurse to join our team as a Utilization Review Specialist. As a key member of our quality improvement team, you will play a critical role in ensuring the highest level of patient care and satisfaction.Key Responsibilities:Conduct clinical assessments, including...
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Utilization Review Coordinator
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Financial Reporting Specialist
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Utilization Review Case Manager
4 months ago
New Canaan, United States Silver Hill Hospital Full timeJob DescriptionJob DescriptionUtilization Review Case ManagerThe UR Case Manager will complete prior authorizations and concurrent reviews for new admissions or existing patients. The UR Case Manger will work with insurance companies and the clinical team, reviewing documentation to determine medical necessity criteria and length of...
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Travel Nurse RN
7 days ago
New York, New York, United States Planet Healthcare Full timeJob SummaryPlanet Healthcare is seeking a skilled Travel Nurse RN to fill a Utilization Review position in a dynamic healthcare setting.Key ResponsibilitiesConduct thorough reviews of patient cases to ensure optimal healthcare utilizationCollaborate with healthcare teams to develop and implement effective care plansAnalyze data to identify trends and areas...
Utilization Review Clinician, Advocate, Virtual
4 months ago
Utilization Review Clinician/Advocate needed for full-time, permanent, remote position.
**Position Responsibilities**:
?Performs telephonic care review and authorization determinations for prospective, concurrent and discharge review with psychiatric and substance use treatment facilities as assigned.
?Determines appropriate level of care related to mental health and substance use treatment for members based on insurance medical necessity level of care criteria.
?Consults with treatment team when requests for services do not meet medical necessity criteria.
?Interacts with Physician Advisors to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases.
?Provides information to members and providers regarding mental health and substance use benefits and community treatment resources.
**Annual Salary**: $60,000.
