Utilization Review Physician

Job DescriptionJob DescriptionRN- Utilization Review Nurse LTSS/DME*Full Time 100% Remote Opportunity*COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGECARE!VillageCare is looking for a self-motivated and passionate RN as Utilization Review Nurse for a Full-Time position. This is an exciting and dynamic position from the comfort of your own home...

Job DescriptionJob DescriptionVivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site.The Utilization Review Physician is the lead clinician for the health plan. Responsible for the administration of medical services for company health plan...

Job DescriptionJob DescriptionVivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site.The Utilization Review Physician is the lead clinician for the health plan. Responsible for the administration of medical services for company health plan...

Job Description:Summary:This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to and...

Job DescriptionJob DescriptionDescription:Zinnia Health is a fast-growing integrated healthcare company. We value our employees and care for our clients. Do you have unique talents that you would like to share with others? We would love to have you join our team!Competitive PayCareer DevelopmentCompetitive Benefits & 401kValues: Integrity, Teamplay, 1%...

VNS Health is seeking a Clinical Utilization Review Nurse for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff We are looking for a detail-oriented and experienced Clinical Utilization Review Nurse to join our team. The successful...

Job 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...

Woodhull Medical and Mental Health Center is attuned to the healthcare issues that matter to the people of North Brooklyn. Woodhull focuses on preventing disease and promoting healthy lifestyles by reaching out to the community at various locations. At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception....

JOB TITLE (#25009): Maternal Nurse Reviewer / Contract - Metropolitan AreaMinimum of 4 years clinical practice experience in a facility or community-based settingGreenlife Healthcare Staffing is currently seeking a Maternal Nurse Reviewer to fill an opening with a Non-profit organization located in New YorkRequirements of the Maternal Nurse Reviewer:Must be...

Job Description: Summary: This position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and healthcare services for members, ensuring compliance with internal and external standards set by regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review. Refer to...

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Manhattan, New York.Job Description & Requirements Specialty: Utilization ReviewDiscipline: RNStart Date: ASAPDuration: OngoingEmployment Type: StaffResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed...

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines...

VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines...

43 New Scotland Avenue Albany, NY 12208Department/Unit:Care Management/Social WorkWork Shift:Day (United States of America)Responsible for Utilization Management, Quality Screening and Delay Management for assigned patients.Salary Range: $31.28 - $51.61 per hour• Completes Utilization Management and Quality Screening for assigned patients.• Applies MCG...

TITLE: UM/Appeals RNLOCATION: Hybrid; New Hyde Park, NY 11042 (preference is for someone to be local to NY and able to come into the office)Looking for 5 RNs to do appeals work under the team handling on average 10 cases a day. These will be a mix between simple and complex cases. They will be reviewing documentation, codes, and more for out of Network bills...

TITLE: UM/Appeals RN **5 of the 10 nurses MUST HAVE their Legal Nurse Consultant Certificate (LCN)***LOCATION: Hybrid; New Hyde Park, NY 11042 (preference is for someone to be local to Long Island and able to come into the office. If in NY and not local to Long Island, nurses can work remotely)Looking for 10 RNs to do appeals work under the team handling on...

Job DescriptionJob DescriptionPOSITION OVERVIEW: The Utilization Manager is responsible for the day to day functions of collaborative communication with external case managers at referring provider facilities and/or managed care organizations (MCO) for data collection, interpretation and certification/recertification from third party payers at pre-admission...

Job DescriptionJob DescriptionPOSITION OVERVIEW: The Utilization Manager is responsible for the day to day functions of collaborative communication with external case managers at referring provider facilities and/or managed care organizations (MCO) for data collection, interpretation and certification/recertification from third party payers at pre-admission...

VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Leads interdepartmental quality improvement activities such as development and engagement, clinical review, clinical...

VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: Ongoing Employment Type: Staff Leads interdepartmental quality improvement activities such as development and engagement, clinical review, clinical...