Nurse Utilization Review Specialist

About the Role:">As a Utilization Review Coordinator, you will play a critical role in ensuring that patients receive the necessary care and services while maintaining high-quality patient outcomes. Your responsibilities will include obtaining insurance precertification/recertification, serving as a liaison with third-party payers, communicating clinical...

Job SummaryWe are seeking an experienced Utilization Review RN to fill a travel nursing position in Philadelphia, Pennsylvania. This 13-week assignment offers a competitive salary and a comprehensive benefits package.Specialty: Utilization ReviewDiscipline: RNDuration: 13 weeks$1400-$2400 per weekShift: 8 hours, daysEmployment Type: TravelThe ideal candidate...

We are seeking a skilled Travel Nurse Case Manager for our Utilization Review team in Oakland, California.About the JobThis is a 13-week assignment with 36 hours per week, working 8-hour shifts. You will be responsible for utilizing your clinical expertise to review and manage patient cases, ensuring efficient use of healthcare...

We are seeking a skilled travel nurse RN to join our team as a Case Manager for Utilization Review. This is a fantastic opportunity to work with a leading healthcare provider in Philadelphia, Pennsylvania.The successful candidate will be responsible for managing the utilization review process, ensuring that patients receive the necessary care and services to...

Job Description: We are seeking an experienced RN to join our team as a Utilization Review Nurse - Insurance Professional & Clinical. This Contract to Hire position offers a challenging opportunity to work with insurance professionals and clinicians.Key Responsibilities:Perform audits and reviews: Conduct regular audits and reviews of delegated entities to...

Medical Solutions Job OpportunityWe are seeking a skilled travel nurse RN Case Manager for a utilization review position in Oakland, California.About the RoleType: Travel NursingDuraction: 13 weeksHours per week: 36 hoursShift: 8 hours, daysBenefitsCompetitive salary: $96.16/hour, estimated annual salary: $198,560/yearDay One medical, dental, and vision with...

Job Title: Utilization Management SpecialistWe are looking for a detail-oriented Utilization Management Specialist to join our team at Progressions in Philadelphia, PA. As a full-time employee, you will have access to a comprehensive benefits package, including medical insurance, dental insurance, vision insurance, life insurance, paid time off, and a 401K...

HEDIS Review Specialists are in high demand to support our clients with their healthcare data needs.Insight Global is currently seeking a Healthcare Data Analyst for a remote contract position working in PA or NJ.This role requires previous experience in HEDIS review and quality checking of FDC/HEDIS nurses.Territories Available:PA NORTH: Montgomery & Bucks...

About the RoleWe are seeking an experienced Healthcare Utilization Expert to join our team at Progressions in Philadelphia, PA. As a full-time employee, you will have access to a comprehensive benefits package, including medical insurance, dental insurance, vision insurance, life insurance, paid time off, and a 401K plan with company match.Job Overview: The...

Performance Development Group is a global leader in providing collaborative advisory services and innovative performance improvement solutions. We are currently seeking an experienced Editorial/QC Specialist to join our team.The ideal candidate will have 8-12 years of experience working as an editor or QC Specialist, with a proven track record of delivering...

A remote contract position is available with Insight Global for a skilled HEDIS (Healthcare Effectiveness Data and Information Set) professional in PA or NJ. This role involves Quality Check of FDC/HEDIS nurses, utilizing healthcare data and software to evaluate medical forms or patient records for compliance with health plans. The ideal candidate will have...

Job OverviewWe are seeking a highly skilled Clinical Utilization Management Specialist to join our team at Open Systems Technologies. This is a contract to hire position that requires the candidate to have experience in managed care, audit and oversight, and case management.">The ideal candidate must have an unrestricted RN license to practice in NJ or PA....

Job TitleUtilization Management RN SpecialistWe are seeking a highly skilled Utilization Management RN Specialist to join our team. The successful candidate will be responsible for conducting audits and monitoring delegated entities to ensure compliance with federal and state laws, accreditation standards, and company policies.Key Responsibilities:Conduct...

About the RoleWe are seeking an experienced Master Utility Systems Specialist to join our team at Whitman, Requardt & Associates, LLP. As a specialist in this role, you will be responsible for designing and developing sustainable urban infrastructure projects that support renewable energy sources.

Temple University Hospital is seeking a skilled Nursing Authorization Specialist to join our team.About the RoleThis position plays a vital role in ensuring efficient and effective authorization processes for patients undergoing treatment at Temple University Hospital. As a key member of the Pre-Certification Department, you will serve as the primary...

Role OverviewWe are seeking a skilled Editorial/QC Specialist to join our team at Performance Development Group. This role is ideal for individuals with experience in editing and reviewing content, ensuring high-quality deliverables that meet client expectations.About the JobThe successful candidate will work closely with our team to review and edit various...

Unlock Your Potential as an ESOP ReviewerWe are seeking a skilled and detail-oriented individual to join our team as an ESOP Reviewer at Transition Finance Strategies LLC. Located in Charlottesville, VA, Columbia, MD, Columbus, OH, Westchester, IL, Pasadena, CA, and Maple Grove, MN, our offices offer a collaborative environment where you can grow your career...

Insight Global is looking for a talented HEDIS nurse reviewer to join their team. As a HEDIS Overreader Registered Nurse, you will be responsible for reviewing healthcare data and software to ensure quality and accuracy.Job SummaryReview healthcare data and software to ensure quality standards are metEvaluate health plans against healthcare facility...

Job SummaryMuller, Inc. is seeking an experienced Dry Utility Estimator to join our civil construction team. This role involves providing high-quality estimates for dry utility projects while maintaining excellent customer relationships.Key Responsibilities:• Review plans and details to ensure accurate costing and proposal submissions• Provide...

About the JobThis is a Contract-to-Hire position with a leading healthcare organization. As a Clinical Utilization Auditor, you will play a critical role in ensuring compliance with regulations and accrediting agencies.The ideal candidate will have strong analytical skills, excellent communication skills, and the ability to work independently. Key...