Clinical Utilization Review Specialist

1 day ago


West Norriton, Pennsylvania, United States Elite Full time
Job Summary

At Elite, we are seeking a skilled Clinical Utilization Review Specialist to join our team in Montgomery County, PA. This is an exciting opportunity to utilize your clinical expertise and knowledge of evidence-based treatment guidelines to review Workers Compensation requests.

Key Responsibilities
  • Evaluate medical data for utilization review requests to determine medical necessity.
  • Collect and analyze relevant data to apply evidence-based guidelines.
  • Review requests and make certification decisions or prepare cases for peer review referral.
  • Coordinate information between injured workers, physicians, employers, therapists, attorneys, and other stakeholders.
Requirements

To be successful in this role, you will need:

  • A valid current LVN, LPN, or RN license in good standing.
  • Minimum 2 years of direct patient care experience.
  • Excellent written and oral communication skills.
  • Ability to read and interpret medical reports and treatment guidelines.
  • Strong personal organizational skills and ability to maintain confidentiality.
  • Intermediate computer skills and experience with WORD and EXCEL documents.
Salary and Benefits

This is a competitive salary position, offering a generous compensation package including benefits and opportunities for career growth. The estimated annual salary for this role is $ $75,000 based on the location and industry standards.


  • Nurse Specialist

    3 weeks ago


    West Norriton, Pennsylvania, United States Suburban Community Hospital Full time

    Job SummaryThe Nurse Specialist will be responsible for providing high-quality patient care in the Emergency Department at Suburban Community Hospital. This role requires a skilled and compassionate Registered Nurse to deliver safe and effective care to patients.Key ResponsibilitiesDeliver patient care utilizing the nursing process of assessment, planning,...


  • West Norriton, Pennsylvania, United States Cardiolgy Consultants of Philadephia Full time

    Cardiology Consultants of Philadelphia is a professional medical organization dedicated to delivering exceptional cardiology care. We are seeking a highly skilled Medical Support Specialist to join our team at our East Norriton, PA location.As a Medical Support Specialist, you will be responsible for providing top-notch patient care and support to our...


  • West Norriton, Pennsylvania, United States Acadia Healthcare Full time

    Job Summary:Acadia Healthcare is seeking a skilled Healthcare Admissions Specialist to join our team. As a key member of our admissions team, you will be responsible for reviewing prospective admissions against approved admission criteria, policies, and procedures. Your primary goal will be to ensure that our patients receive the highest level of care and...

  • Clinical Supervisor

    4 weeks ago


    West Norriton, Pennsylvania, United States Aveanna Healthcare Full time

    Job Title: Clinical SupervisorRequisition #:198230Location:East Norriton, PA 19401Category:NursingSalary:$75,000.00 - $80,000.00 per yearJob SummaryAveanna Healthcare is seeking a skilled Clinical Supervisor to join our team. As a Clinical Supervisor, you will be responsible for leading and mentoring a team of healthcare professionals to provide high-quality...


  • West Norriton, Pennsylvania, United States Thomas Jefferson University & Jefferson Health Full time

    In line with our mission to improve lives, we are seeking a highly skilled Medical Laboratory Specialist to join our team at Thomas Jefferson University & Jefferson Health.This role involves performing laboratory analysis following established procedures, including PCR-based molecular assays and verifying laboratory findings in a timely and accurate...


  • West Norriton, Pennsylvania, United States Suburban Hospital Full time

    About the Role:The Diagnostic Imaging Specialist will work collaboratively within a multi-disciplinary team to provide quality images. This role supports the Radiologist in the performance of diagnostic and therapeutic procedures, processing and transmission of images to PACS.Responsibilities:Collaborate with the Radiologist to provide quality imagesAssist...

  • Nurse Specialist

    4 weeks ago


    West Norriton, Pennsylvania, United States BAYADA Home Health Care Full time

    Job Description & RequirementsBAYADA Home Health Care is seeking a skilled Registered Nurse (RN) to provide high-quality care to clients in their homes.Specialty: Home HealthDiscipline: RNDuration: OngoingEmployment Type: StaffBAYADA offers a comprehensive benefits plan that includes paid holidays, vacation and sick leave, vision, dental and medical health...

  • Nurse Specialist

    4 weeks ago


    West Norriton, Pennsylvania, United States BAYADA Home Health Care Full time

    Registered Nurse (RN) - Home Health VisitsBAYADA Home Health Care is seeking a skilled and compassionate Registered Nurse (RN) to provide high-quality home health care services to our clients in the East Norriton, Pennsylvania area.Responsibilities:Follow a designated care plan in accordance with patient's needsMake home visits to clients in designated...


  • West Norriton, Pennsylvania, United States Thomas Jefferson University & Jefferson Health Full time

    Thomas Jefferson University & Jefferson Health is seeking a part-time Pathologist to join our team of experts in anatomic and clinical pathology diagnostic services. Our group of pathologists utilizes a generalist staffing model and provides a full range of hospital-based diagnostic services.Fellowship training in Cytopathology or Gastrointestinal Pathology...


  • West Chester, Pennsylvania, United States Senior Living Recruiting Specialist Full time

    Unlock Your Potential in Senior CareWe're seeking a compassionate and dedicated Certified Nursing Assistant to join our team at Senior Living Recruiting Specialist. As a key member of our care team, you'll play a vital role in providing exceptional support to our residents, ensuring their physical, emotional, and social needs are met.Key...


  • West Norriton, Pennsylvania, United States Prime Healthcare Full time

    Prime Healthcare is committed to delivering high-quality medical care to our communities. As a Licensed Practical Nurse (LPN) in our Emergency Department, you will play a vital role in providing compassionate care to patients in need.Key Responsibilities:Provide direct and indirect patient care services, utilizing clinical competence within the scope of...


  • West Norriton, Pennsylvania, United States Resilience Government Services, Inc. Full time

    Job SummaryResilience is a technology-focused biomanufacturing company that's changing the way medicine is made. We're building a sustainable network of high-tech, end-to-end manufacturing solutions to better withstand disruptive events, serve scientific discovery, and reach those in need.Job ResponsibilitiesSupports and/or acts as engineering work stream...


  • West Norriton, Pennsylvania, United States PlanetHealthcare Full time

    Job Title: Diagnostic Imaging Specialist - Travel OpportunityJob Summary:Planet Healthcare is seeking a skilled Diagnostic Imaging Specialist to join our team for a travel opportunity. As a Diagnostic Imaging Specialist, you will be responsible for operating imaging equipment, preparing patients for exams, and maintaining a clean and safe environment. This...


  • West Norriton, Pennsylvania, United States Resilience Government Services, Inc. Full time

    Job SummaryWe are seeking a highly skilled Senior Facilities Engineer to join our team at Resilience. As a key member of our engineering team, you will be responsible for the performance and reliability of plant utility systems and equipment at our cell therapy facility in East Norriton, PA.Key ResponsibilitiesSupport and lead engineering work streams on...


  • West Norriton, Pennsylvania, United States Resilience Corp. Full time

    Job SummaryWe are seeking a highly skilled Senior Facilities Engineer to join our team at Resilience Corp. in East Norriton, PA. As a key member of our engineering team, you will be responsible for the performance and reliability of plant utility systems and equipment.Key ResponsibilitiesSupports and/or acts as engineering work stream lead on site capital...


  • West Norriton, Pennsylvania, United States Resilience Government Services, Inc. Full time

    Job SummaryWe are seeking a highly skilled Senior Facilities Engineer to join our team at Resilience. As a key member of our engineering team, you will be responsible for the performance and reliability of plant utility systems and equipment at our cell therapy facility in East Norriton, PA.The successful candidate will have a strong technical background in...

  • Nurse Specialist

    4 weeks ago


    West Norriton, Pennsylvania, United States BAYADA Home Health Care Full time

    About BAYADA Home Health CareWe are seeking a compassionate and skilled Registered Nurse (RN) to join our team of healthcare professionals in providing high-quality home health care services to our clients. As a Registered Nurse with BAYADA, you will have the opportunity to make a meaningful difference in the lives of our clients and their families.As a...

  • Medical Assistant

    3 weeks ago


    West Norriton, Pennsylvania, United States Cardiolgy Consultants of Philadephia Full time

    Cardiology Consultants of Philadelphia is a professional medical organization dedicated to delivering exceptional cardiology care. We are seeking a highly skilled Medical Assistant to join our team at our East Norriton, PA office. The ideal candidate will have a strong background in medical assisting and excellent communication skills.Responsibilities:Work...


  • West Norriton, Pennsylvania, United States Suburban Community Hospital Full time

    OverviewSuburban Community Hospital is seeking a skilled Certified Registered Nurse Anesthetist to join our team. As a CRNA, you will be responsible for providing high-quality anesthesia care to patients undergoing various medical procedures.With a strong commitment to quality, compassion, and community, our hospital is an ideal place to advance your career...

  • Staff Nurse

    3 weeks ago


    West Norriton, Pennsylvania, United States Thomas Jefferson University & Jefferson Health Full time

    As a Staff Nurse at Thomas Jefferson University & Jefferson Health, you will play a vital role in delivering high-quality patient care in our Telemetry Unit. We are seeking a dedicated and compassionate Registered Nurse to join our team on a part-time basis, working nights.Key Responsibilities:Provide professional nursing care to patients within a specified...