Licensed Utilization Review Specialist

Job SummaryWe are seeking a highly skilled Licensed Utilization Review II to join our team at Elevance Health. As a key member of our medical management team, you will play a critical role in ensuring the appropriate and consistent administration of plan benefits.Key ResponsibilitiesWork with healthcare providers to collect clinical information required for...

About the RoleWe are seeking a skilled Licensed Utilization Review II to join our team at Elevance Health. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate and consistent administration of plan benefits.Key ResponsibilitiesCollaborate with healthcare providers to collect clinical information required for...

Job SummaryWe are seeking a skilled Licensed Utilization Review professional to join our team at Elevance Health. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate and consistent administration of plan benefits.Key ResponsibilitiesCollaborate with healthcare providers to collect clinical information required...

Job SummaryWe are seeking a highly skilled Licensed Utilization Review II to join our team at Elevance Health. As a key member of our medical management team, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care possible.Key ResponsibilitiesConduct thorough reviews of precertification requests,...

About the RoleWe are seeking a skilled Licensed Utilization Review II to join our team at Elevance Health. As a key member of our healthcare team, you will play a critical role in ensuring the appropriate and consistent administration of plan benefits.Key ResponsibilitiesCollaborate with healthcare providers to collect clinical information required for...

Job SummaryWe are seeking a skilled Licensed Utilization Review II to join our team at Elevance Health. As a key member of our clinical review team, you will play a critical role in ensuring the appropriate and consistent administration of plan benefits.Key ResponsibilitiesConduct pre-certification, inpatient, retrospective, out-of-network, and...

Job Title: Licensed Utilization Review LeadAt Elevance Health, we are seeking a highly skilled Licensed Utilization Review Lead to join our team. As a key member of our healthcare team, you will play a critical role in ensuring that our members receive the highest quality care while maintaining cost-effectiveness.Job Summary:The Licensed Utilization Review...

Job Title: Utility SpecialistJoin Lakeshore Employment Inc. as a Utility Specialist and take on a challenging role that requires a unique blend of technical expertise and business acumen.Job Summary:The Utility Specialist will be responsible for overseeing all utility-based projects, analyzing and tracking utility trends, and ensuring compliance with local...

Job Title: Utility SpecialistJoin Lakeshore Employment Inc. as a Utility Specialist and take on a challenging role that requires a unique blend of technical expertise and business acumen. As a key member of our team, you will be responsible for overseeing all utility-based projects, analyzing and tracking utility trends, and ensuring compliance with local...

Job OpportunityDenovo Review, a top-rated plaintiff personal injury firm based in Tampa, FL, is seeking a highly skilled Litigation Paralegal to join their team.Key Responsibilities:Provide strong support to attorneys in plaintiff personal injury litigation casesAssist in organizing and prioritizing tasks, ensuring timely completion and high attention to...

Job SummaryLakeshore Employment Inc is seeking a highly skilled Utility Operations Specialist to join our team. As a key member of our operations team, you will be responsible for overseeing all utility-based projects, analyzing and tracking utility trends, and ensuring compliance with local and state agencies.Key ResponsibilitiesProject Management: Plan,...

Job Title: Document ReviewerKLDiscovery is seeking attorneys who are actively licensed in any U.S. jurisdiction to join our team as Document Reviewers. As a Document Reviewer, you will play a critical role in supporting our clients' litigation needs by reviewing documents for complex litigation matters using an electronic review platform.Key...

About the RoleWe are seeking a skilled RN Utilization Management Specialist to join our team at AdventHealth. As a key member of our healthcare team, you will play a critical role in ensuring that our patients receive the highest quality care while minimizing unnecessary costs.Key ResponsibilitiesConduct thorough reviews of patient records to determine the...

Job OverviewDenovo Review, a top-rated plaintiff personal injury firm based in Tampa, FL, is seeking a highly skilled Litigation Paralegal to join their team. The ideal candidate will have a minimum of 5 years of experience in plaintiff personal injury litigation and possess excellent organizational, communication, and client service skills.Key...

Job Title: Utilization Management Nurse SpecialistJob Summary:ReqRoute Inc is seeking a skilled Utilization Management Nurse to join our team. As a Utilization Management Nurse, you will be responsible for managing the utilization of healthcare services and resources. This is a contract position that can be worked remotely.Key Responsibilities:• Manage the...

Job SummaryUnder general supervision and following established policies, procedures, and professional guidelines, the Medical Auditor performs medical record reviews to establish the accuracy of patient billing and to monitor departmental compliance with charge policies. Identifies and recommends corrective actions to departmental Directors when repeated...

Nurse Reviewer - Fraud, Waste, and Abuse Clinical ReviewsThe Nurse Reviewer - FWA Clinical Reviews is a critical role within our organization, responsible for conducting thorough clinical reviews to identify, investigate, and prevent healthcare fraud, waste, and abuse.Key Responsibilities:Conduct in-depth clinical reviews of medical records, claims data, and...

Job Title: Utilization Management NurseReqRoute Inc is seeking a skilled Utilization Management Nurse to join our team. As a Utilization Management Nurse, you will play a critical role in ensuring that patients receive the necessary care and services to achieve optimal health outcomes.Key Responsibilities:Utilize clinical expertise to review and manage...

Job OpportunityDenovo Review is seeking an ambitious attorney to join its First-Party Property division in Tampa. Responsibilities:Manage a comprehensive caseload from initiation through post-trial.Participate in hearings, depositions, mediations, and trials.Draft pleadings, manage discovery and responses, file motions, and create other legal...

Nurse Reviewer - Fraud, Waste, and Abuse Clinical ReviewsAt Zenith American Solutions, we are seeking an experienced Nurse Reviewer to join our team in conducting clinical reviews to identify, investigate, and prevent healthcare fraud, waste, and abuse.Key Responsibilities:Conduct thorough clinical reviews of medical records, claims data, and other relevant...