utilization review

Utilization Review Coordinator Manages the administrative components of utilization review for all levels of care and all payers. Serves as the organization's central point of accountability for authorization tracking, assuring that prior authorizations, continued stay reviews, requests for information, reconsiderations, and retrospective reviews are...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Full Time MO - St Louis, St. Louis, MO, US Location: St. Louis, MO Elevate your career with an organization that truly cares. Camber is proud to announce a Work Wellbeing Score of 83, reflecting our deep...

Please, no agencies or recruiters, only W2 applicants.Vega Consulting is staffing a Utilization Review Specialist for our direct Healthcare client. This is a 6-month contract, hybrid role. Candidates license for Maryland, VA or Wash DC. (RN or LPN).The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and...

Your experience matters At Columbus Springs-East, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Full Time MO - St Louis, St. Louis, MO, US Location: St. Louis, MO Elevate your career with an organization that truly cares. Camber is proud to announce a Work Wellbeing Score of 83, reflecting our deep...

MACON COMMUNITY HOSPITAL Position Description Department Name: Care Management Employee Name: Job Title: Utilization Review Nurse Effective Date: Reports to (Title): Care Management Director Supervises: (Positions) N/A I have reviewed these job requirements and verify that I can perform all essential functions of this position. I understand that...

Job Summary and Responsibilities The Utilization Review Nurse is responsible for ensuring the medical necessity, appropriateness, and efficiency of inpatient hospital services. This role involves conducting concurrent and retrospective reviews of patient charts, applying standardized clinical criteria to validate admission status, and coordinating with...

PRN Utilization Review Admin Good Hope Hospital - Erwin, NC 28339 Description Our mission is to inspire and empower people to seek and maintain recovery and health. Daymark Recovery Services, Inc. is a mission driven, comprehensive community provider of culturally sensitive mental health and substance abuse services. Comprehensive Benefits Package Medical,...

JOB DESCRIPTION: Under the direction of the VP of Case Management & Continuing Care, the Sr. Director of Utilization Review (UR) is responsible for overseeing the development, implementation, and performance management of Utilization Review services performed across the Tenet enterprise. Leads Tenet Hospital case management operations to develop and...

This is a full time, day shift position, the schedule is 8am-4:30pm. This role requires alternating weekends and holiday shifts. The hyrbird schedule is for up to two days remote and three days in office. Job Summary: The Case Manager serves as a key member of the patient care delivery team in a Magnet Recognized large tertiary academic medical...

Job Description /n GLC On-The-Go is seeking a travel nurse RN Case Management for a travel nursing job in Fort Myers, Florida. Job Description & Requirements/n /n - Specialty: Case Management /n - Discipline: RN /n - Start Date: 10/26/2026 /n - Duration: 13 weeks /n - 40 hours per week /n - Shift: 8 hours /n - Employment Type: Travel /n /n Registered...

Position SummaryThe Manager of Utilization Management provides daily oversight for Case Management teams (which includes RN’s, Social Workers, and Coordinators). The Manager of Utilization Management is responsible for ensuring high quality, cost-effective, and appropriate allocation of member services, treatments, and resources. The Manager of Utilization...

Job DescriptionSolomon Page is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Jamaica Plain, Massachusetts. Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 10/15/2026Duration: 11 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelOur client is looking to add a...

Utilization Review Liaison Salary Range: $32.35 - $43.63 + applicable differentials Under the general supervision of the Director of Case Management, the Utilization Review (UR) Liaison is responsible for assisting Utilization Review Case Managers. The UR Liaison is responsible for coordinating insurance reviews and issuance of authorization numbers through...

PT Utilization Review Coordinator This position is responsible for monitoring the treatment activities offered to the patient, interfacing with the treatment team/managed care organizations to ensure quality patient care and collaborating with referring professionals for continuity of care. Complete concurrent reviews for mental health and dual diagnosis...

Job DescriptionGLC On-The-Go is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Torrance, California. Job Description & RequirementsSpecialty: Utilization ReviewDiscipline: RNStart Date: 10/12/2026Duration: 13 weeks40 hours per weekShift: 8 hoursEmployment Type: TravelGLC On-The-Go Job ID # . Pay package is based on 8...

Job Description /n Solomon Page is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Jamaica Plain, Massachusetts. Job Description & Requirements/n /n - Specialty: Utilization Review /n - Discipline: RN /n - Start Date: 10/15/2026 /n - Duration: 11 weeks /n - 40 hours per week /n - Shift: 8 hours, days /n - Employment...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are We serve faithfully by doing what's right with a joyful heart. We never settle by constantly...

Avenues Recovery Center is Now Hiring: Utilization Review Specialists Avenues Recovery Center is a nationwide network of drug and alcohol rehabilitation centers with eighteen locations across seven states. We provide highly individualized, evidence-based treatment in clean, modern settings across all levels of care including detox, residential, PHP, IOP, and...

Baptist Health is seeking a Registered Nurse with associates-level education to conduct chart reviews for clinical financial resource utilization. The role coordinates with the care team to improve patient outcomes while decreasing length of stay and minimizing delays and denied days.Strong communication with payers is essential for efficient reimbursement....