utilization review jobs in Philadelphia

Travel RN - Case Management/Utilization Review - Case ManagementAmerican TravelerPhiladelphia, Pennsylvania, United StatesPosition ID: P-753603Position status: OpenAssignment type: travelShift: DaysLength (weeks): 13Openings: 2Start date: 2026-10-19T00:00:00.000Z$2,488.00/week (estimated advertised weekly pay)DescriptionAmerican Traveler is hiring a Case...

Utilization Management RNWe’re actively seeking qualified candidates for a Utilization Management Coordinator / RN opportunity supporting inpatient utilization management and care coordination. This position is remote; however, candidates must reside in Pennsylvania, New Jersey, or Delaware to be eligible for potential conversion.Position OverviewThe...

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The...

The Utilization Management (UM) Nurse Supervisor is responsible for providing direct leadership and oversight to the UM nursing team. This role ensures team performance, accountability, and professional development by conducting regular 1:1s, managing performance reviews, and driving compliance with organizational, state, and federal requirements. The...

Job Title: Utility Accounting SMELocation : Philadelphia PA 19107Duration : 12 Months Note: Onsite interview is must. This is Hybrid Role. Position overview / Statement of WorkThe Lead Accounting Subject Matter Expert (SME) serves as the functional authority for accounting and financial business processes throughout the CIS implementation. This individual...

Job Title: Regional EHS Manager - Utility ConstructionLocation: Hybrid - Mid-Atlantic RegionSalary: $135,000-$170,000 + Bonus and PerksSkills: Utility Construction, OSHA, Transmission, Distribution, Substation, InfrastructureAbout The Company / The Opportunity:Join a well-established leader in the utilities industry supporting critical infrastructure...

Vice President of Bill Review Operations About the Company Innovative healthcare solutions provider specializing in insurance services Industry Insurance Type Privately Held Founded 2004 Employees 501-1000 Categories Insurance Specialties bill review out-of-network repricing primary ppo and alternative repricing administration edi and...

Job TitlePosition located in a Bureau of Prisons Correctional Institution. Works with the Medical Referral Centers (MRC) and field institutions to collect and provide data that will enhance appropriate and timely medical and mental health designations, allocation of institution resources by analyzing bed utilization, length of stay, and utilization of...

Corrections ProfessionalsCorrections professionals who foster a humane and secure environment and ensure public safety by preparing individuals for successful reentry into our communities.

Job DescriptionJob DescriptionAbout Burns:Burns Engineering provides professional engineering design and project management services for transportation, facilities, and infrastructure projects. We help our clients attain their strategic goals and initiatives through successful large-scale infrastructure projects. Burns' full-service capabilities include...

Company DescriptionA best-in-class city that attracts best-in-class talent, Philadelphia is an incredible place to build a career. From our thriving arts scene and rich history to our culture of passion and grit, there are countless reasons to love living and working here. With a workforce of over 30,000 people, and more than 1,000 different job categories,...

OverviewArcGIS Solutions are industry-specific configurations of ArcGIS designed to improve operations and enhance services. Our team’s mission is to develop solutions that help agencies maximize their investment in location-based data and technology. As the Product Engineer II – Utilities, you will collaborate with customers, industry teams, and other...

Utilization Management Coordinator - Philadelphia Malvern Treatment Centers is currently seeking a full time Utilization Management Coordinator for our location in Philadelphia! This position is a full time, benefit eligible position and reports to our brand new location at 3905 W. Ford Road Philadelphia, PA 19131. Position Summary: To conduct continued stay...

Amazon is now hiring work from home workers in your area. Great pay and flexible hours. Easy apply online. This position is a work from home position at Amazon. You will not need to come into the office. No Experience Needed. Benefits: Health Insurance, 401K, Vacation& PTO. Apply now! An Amazon work from home Customer Service Associate is a critical part of...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

A nationally recognized architecture, engineering, interior design, and planning firm is seeking a Structural Engineer to join its Philadelphia office. This individual will support the design and execution of a wide range of building projects while working alongside experienced structural engineers, architects, and multidisciplinary project teams. The role...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...

Provides timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria while located in a state or territory of the United States.Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated.Provides...