2mo
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Utilization Specialist
Magee, Mississippi, United States
OnsiteFull Time
2+ YOEMonitor service utilization to optimize reimbursement; coordinate reviews with managed care; ensure medical necessity; report on utilization and length of stay.
1mo
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Utilization Assistant
Williamsburg, Virginia, United States
OnsiteFull Time
Supports utilization review and insurance verification, conducts benefit checks and pre-certifications, reviews medical records for level-of-care appropriateness, coordinates with payers and business office, and documents utilization management activities.
1d
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Utilization Reviewer
Largo, Maryland, United States
OnsiteFull Time
Active Maryland RN licensure (or compact eligibility) required; utilization/case management and acute care experience preferred; CPUR preferred; strong communication and analytical skills.
2mo
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Utilization Specialist
Valdosta, Georgia, United States
OnsiteFull Time
2+ YOEMonitor service utilization to optimize reimbursement; liaise with managed care organizations; perform reviews for medical necessity; manage pre-authorization/appeals; ensure accurate documentation and reporting.
1mo
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Utilization Manager
Austin, Texas, United States
$75k-$96k/yr OnsiteFull Time
Master's in Psychology, Counseling, or Social Work; Texas license (RN, RN-APN, PA, LCSW, LPC, or LMFT); valid driver's license and clean driving record; perform utilization reviews, authorizations, and 24/7 hotline coverage.
3w
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Utilization Specialist
Lincoln or United States
HybridFull Time
2+ YOEEnsure medical necessity and authorization for behavioral health services; conduct utilization reviews; manage authorizations, appeals, and documentation; proficiency with EHRs and data reporting; 2 years relevant experience; HS diploma required; clinical license preferred.
1mo
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Utilization Coordinator PRN
Louisville, Kentucky, United States
$20/hr OnsiteTemporary
1+ YOELPN and/or Bachelor/Masters in Social Work or Psychology; Licensed LPN in Kentucky; 1 year Utilization Management experience; 3-5 years preferred.
3mo
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Utilization Specialist - PRN
El Paso or United States
OnsiteContract
2+ YOEMonitor service utilization to optimize reimbursement; liaison with managed care; review medical necessity; requires high school diploma; clinical experience with relevant population; licensure preferred.
2w
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Utilization Management Nurse
Nashville, Tennessee, United States
OnsiteFull Time
3+ YOEPerform prospective/concurrent/retrospective utilization reviews, analyze trends, collaborate with providers, and document reviews; RN license and 3+ years utilization management experience required.
1d
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RN Utilization Manager (PRN)
Covington, Louisiana, United States
OnsitePart Time
Graduate of accredited nursing school with active Louisiana RN license; experience in hospital nursing and utilization management preferred; knowledge of utilization review, CPT/ICD-9 and DRG principles; strong communication and organizational skills.
2w
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Utilization Review Specialist
United States
OnsiteFull Time
2+ YOEBachelor's degree in healthcare,2+ years in utilization review or case management,knowledge of medical terminology,authorization processes,and payer guidelines;EHR familiarity and utilization review certification preferred.
Electronic Health Records (EHR)
2d
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Utilization Review
Marlboro Township, New Jersey, United States
OnsiteFull Time
2+ YOE2+ years utilization review, case management, medical billing, or behavioral healthcare experience preferred; high school diploma required; knowledge of Medicaid, commercial insurance, ASAM criteria; strong communication and organizational skills.
Microsoft Office, Electronic Health Record (EHR)
2mo
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Director, Utilization Management
New York, New York, United States
$155k-$237k/yr OnsiteFull Time
Senior-level leadership in utilization management with healthcare regulatory knowledge.
1w
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UTILIZATION SPECIALIST-E.D.
Middleburg Heights, Ohio, United States
OnsiteFull Time
5+ YOEBSN preferred; current Ohio RN license required; minimum 5 years clinical nursing experience; utilization/case management experience and Interqual/MCG screening criteria preferred; strong critical thinking, communication, and computer skills.
Interqual, MCG
1mo
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Utilization Review Coordinator
Franklin or United States
OnsiteFull Time
0+ YOEManage utilization review processes, secure authorizations, communicate with payers, document authorization activity, and support process improvement. H.S. diploma/GED required; 0-2 years utilization review or admissions experience.
2mo
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UTILIZATION REVIEW DIRECTOR
Lake Charles, Louisiana, United States
OnsiteFull Time
1+ YOEOversee utilization review and discharge planning in compliance with CMS, state regulations; strong analytical and communication skills.
2mo
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Utilization Review Specialist
Tulsa, Oklahoma, United States
OnsiteFull Time
2+ YOEBachelor’s degree in related field required; experience in lieu of degree considered; 2+ years health care/utilization review experience.
2mo
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Utilization Management Nurse
United States
$80k-$95k/yr RemoteFull Time
3+ YOERN with 3-5 years in utilization management; risk-based care experience; data-driven decision making; strong communication and leadership.
1mo
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Manager- Utilization Management
Greenville, North Carolina, United States
$92k-$134k/yr OnsiteFull Time
3+ YOEBachelor's degree in nursing, 3+ years related experience, experience with utilization review, regulatory compliance, and clinical decision tools (MCG/InterQual).
MCG, InterQual
1mo
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Utilization Management Supervisor
United States
$68k-$106k/yr RemoteFull Time
5+ YOE2+ MgmtBachelor's in Nursing; active Indiana RN license; 5 years nursing/patient care experience; 2 years utilization or case management preferred.
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