We have other current jobs related to this field that you can find below
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Utilization Review Physician
3 months ago
New York, United States Vivo HealthStaff Full timeJob 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...
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Utilization Management Reviewer
1 month ago
New York, New York, United States tapwage Full timeJob 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...
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Utilization Review Coordinator
2 days ago
New York, New York, United States StateJobsNY Full timeJob SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a key member of our healthcare operations team, you will be responsible for analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...
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Utilization Review Coordinator
13 hours ago
New York, New York, United States StateJobsNY Full timeJob SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a key member of our healthcare operations team, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...
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Utilization Review Coordinator
13 hours ago
New York, New York, United States StateJobsNY Full timeJob SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at StateJobsNY. As a key member of our healthcare operations team, you will play a critical role in analyzing and evaluating the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Key...
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Utilization Review Nurse
4 weeks ago
New York, United States Village Care Full timeJob DescriptionJob DescriptionRN- Utilization Review Nurse LTSS*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 as...
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RN Utilization Review
4 weeks ago
New York, New York, United States V R Della IT Services Private Limited Full time## Job OverviewWe are seeking a dedicated Utilization Review Nurse to join our healthcare team. The ideal candidate will be responsible for reviewing medical records to ensure that patients receive necessary care and treatment while optimizing healthcare resources.-*Job Description**Initial and concurrent Status Reviews, MDR's, Denial work.*Requirements**RN...
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Healthcare Utilization Review Specialist
8 hours ago
New York, New York, United States VNS Health Full timeAbout the JobVNS Health is seeking a skilled healthcare professional to lead interdepartmental quality improvement activities, focusing on clinical review, risk management, and patient satisfaction.Key ResponsibilitiesConduct thorough clinical assessments, including medication reconciliations, post-discharge transitions of care, and follow-up...
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Utilization Review Case Manager
3 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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Utilization Review/Management Coordinator
2 months ago
New York, United States NYC Health Hospitals Full timeWoodhull 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....
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RN Care Manager
15 hours ago
New York, New York, United States Metroplus Health Plan Inc Full timeJob SummaryMetroPlus Health Plan Inc is seeking a skilled RN Care Manager to join our team. As a RN Care Manager, you will be responsible for developing, facilitating, and monitoring care plans for our members. You will work closely with members, their families, primary care physicians, and other healthcare providers to ensure that our members receive the...
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New York, United States Dane Street Full timeDane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income. This is a telework opportunity for physicians providing a caseload customized to your schedule. Our...
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Utilization Review Manager
3 days ago
New Baltimore, United States Harbor Oaks Hospital Full timeOverview:Harbor Oaks Hospital is looking for a PRN - Utilization Review Manager to join our team!Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI.Non-Exempt PositionMonday - Friday - Day Shift (2 days per week)Rate of Pay:...
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Utilization Management Reviewer
1 month ago
New York City, United States tapwage Full timeJob 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...
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New York, United States VNS Health Full timeVNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Manhattan, New York.Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: ASAPDuration: OngoingEmployment Type: StaffResolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines Managed Long...
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Utilization Review Nurse
3 months ago
43 New Scotland Avenue Albany, NY 12208, United States Albany Medical Center Full time43 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...
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Utilization Review Manager
6 days ago
New Baltimore, MI, United States Harbor Oaks Hospital Full timeOverview:Harbor Oaks Hospital is looking for a PRN - Utilization Review Manager to join our team!Harbor Oaks Hospital, New Baltimore's leading Mental Health and Addiction Treatment Center is seeking a passionate Utilization Review Manager to work at our facility in New Baltimore, MI.Non-Exempt PositionMonday - Friday - Day Shift (2 days per week)Rate of Pay:...
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Utilization Manager
1 month ago
New York, United States PROMESA R.H.C.F. Full timeJob 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...
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Utilization Manager
3 months ago
New York, United States PROMESA R.H.C.F. Full timeJob 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...
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Physician - Internal Medicine
9 hours ago
New York, New York, United States Archway Physician Recruitment Full timePosition OverviewWe are seeking a dedicated Internal Medicine Physician to join our healthcare team. This role offers a full-time, permanent opportunity focused on outpatient care.Key ResponsibilitiesProvide comprehensive primary care services to patients.Utilize flexible scheduling to accommodate patient needs.Collaborate with a team of medical...
Utilization Review Physician
2 months ago
Vivo 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 utilizing the evidence-based medical policies and clinical guidelines of the plan, to ensure the appropriate and most cost-effective medical care is accessible and delivered to our members. Drives direction of the plan related to cost of care, clinical initiatives and population health management and outcomes.
Will function as the clinical lead, working alongside state plan president as the team interfaces with state regulators, providers and market facilities.
Requirements:
- Board Certification in a specialty certified by either the American Board of Medical Specialties or American Osteopathic Association
- Unrestricted Medical License in the State of New York
- Minimum of 10 years of clinical practice post residency
