719 utilization jobs at 263 companies in Philadelphia, PA
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Utilization Review Coordinator
Allentown, Pennsylvania, United States
$20/hr RemoteFull Time
3+ YOEAssociate degree required, 3+ years utilization review or related healthcare experience, intermediate Microsoft Office/Excel skills, knowledge of precertification/appeals and medical records.
Microsoft Excel, Microsoft Word, Microsoft Office
1w
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Utilization Management Nurse
Philadelphia, Pennsylvania, United States
$92k-$117k/yr OnsiteFull Time
5+ YOEAssess clinical data for medical necessity, coordinate utilization reviews, validate authorizations with payers and physicians; requires RN (PA), 5+ years acute clinical nursing, knowledge of payer processes and portal navigation.
Microsoft Office, InterQual
2mo
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Utilization Review Specialist
Chadds Ford, Pennsylvania, United States
HybridFull Time
1+ YOEBachelor's degree in a related field, 1+ years utilization review/case management or behavioral health revenue cycle experience, strong understanding of medical necessity and authorization processes, attention to detail, and strong communication skills.
EHR
1mo
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Utilization Management Coordinator - Philadelphia
Philadelphia, Pennsylvania, United States
$28-$35/hr OnsiteFull Time
Conduct concurrent utilization reviews for psychiatric and residential drug/alcohol clients using ASAM criteria; coordinate appeals, maintain authorization and denial logs, and communicate with payers and treatment teams.
Microsoft Office
1mo
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Utilization Management Coordinator - Philadelphia
Philadelphia, Pennsylvania, United States
$28-$35/hr OnsiteFull Time
Master's degree or nursing graduate with Pennsylvania licensure; knowledge of ASAM and medical necessity criteria; utilization review experience preferred; Microsoft Office and billing experience; strong communication and documentation skills.
Microsoft Office
1mo
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Manager Utilization Review - FT - Day - Utilization Resource Mgmt Trenton NJ
Trenton, New Jersey, United States
$98k-$128k/yr OnsiteFull Time
4+ YOEBSN required (ADN with additional experience may be considered), active NJ RN, BLS recommended, 4+ years nursing experience with utilization review/case management, strong analytical and leadership skills.
1mo
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Utilization Specialist- OMY
Philadelphia, Pennsylvania, United States
OnsiteFull Time
2+ YOEBachelor's in human services/care management, 2 years mental health or social services experience, familiarity with EHRs, proficient with Microsoft Office, strong communication and analytical skills.
EHR, Microsoft Excel, Microsoft Word, Microsoft PowerPoint
2w
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Utilization Review Coordinator – Behavioral Health
Jackson Township, New Jersey, United States
OnsiteFull Time
1+ YOEManage authorization workflows and client caseloads, collaborate with clinical and billing teams, maintain accurate electronic UR documentation; high school diploma/GED required; 1+ year healthcare experience preferred.
1w
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Manager of Utilization Management
Philadelphia, Pennsylvania, United States
FieldFull Time
5+ YOE2+ MgmtRequires an RN license, 5+ years in discharge planning and care coordination, 2+ years management or 4+ years supervisory experience, clinical leadership, data analysis, and Microsoft Office proficiency.
Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, MCG, InterQual, Electronic Medical Record (EMR)
1mo
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Utilization Review Per Diem Elkins Park
Philadelphia, Pennsylvania, United States
OnsitePart Time
2+ YOEMaster of Social Work and 2 years hospital social work experience required; performs psychosocial assessment, discharge planning, counseling, and multidisciplinary collaboration.
1w
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Wound Care Utilization Management RN
Indianapolis or Iselin or Tampa or Miami or Wilmington or Cincinnati or St. Louis or Walnut Creek or Las Vegas or Woburn or Grand Prairie or Chicago or California or Illinois or Massachusetts or Nevada or New Jersey
$39-$56/hr RemoteFull Time
3+ YOERequires an associate degree in nursing or equivalent background, 3+ years of healthcare experience, active unrestricted RN license, and wound-care certification such as WOCN or CWS.
medical records
5d
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Business Finance Revenue Cycle Utilization Manager
Chicago or Austin or Atlanta or United States or Denver or Detroit or Philadelphia or Houston or Tampa or Dallas or Charlotte or Raleigh or Louisville
RemoteFull Time
5+ YOE3+ MgmtBachelor's degree or 5+ years relevant experience, prior management experience, 3–5 years managing hourly staff, strong communication and analytical skills, and revenue cycle or healthcare systems experience.
BrainTree, AVATAR, iserve, Salesforce, EMR, SOX 404
3w
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RN Utilization Management - Day Shift
Newark, Delaware, United States
$86k-$137k/yr OnsiteFull Time
3+ YOEDE or compact RN license, Bachelor’s in Nursing required, minimum 3 years acute care RN and 3 years utilization management, denial management and insurer experience, 8 CEUs/year in utilization/case management.
1w
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Meter Reader Start
Bethlehem, Pennsylvania, United States
OnsiteFull Time
High school diploma, Pennsylvania driver's license, basic utility and construction skills, computer aptitude, ability to work outdoors in all weather, and ability to lift 50 pounds.
2d
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Water/Wastewater Treatment Plant Operator
Philadelphia or Plymouth Meeting
FieldPart Time
1+ YOEHigh school diploma or equivalent, 1+ year mechanical experience, ability to read meters and technical information, maintain records, analyze data, calculate chemical doses, and operate treatment equipment.
PADEP
2w
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Full-Time Water/Wastewater Operator
Doylestown, Pennsylvania, United States
FieldFull Time
5+ YOEHigh school diploma, minimum 5 years operations/engineering experience; water/wastewater license preferred.
5d
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Assistant Plant Operator
Westville, New Jersey, United States
$38-$45/hr OnsiteFull Time, Part Time
2+ YOERequires a high school diploma or GED, two years of power plant operations or three years of related experience, mechanical skills, and steam power plant knowledge.
4d
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Operator, Water Treatment
Royersford, Pennsylvania, United States
OnsiteFull Time
1+ YOEHigh school diploma or equivalent, 1–3 years of experience, computer skills with Microsoft Word, Microsoft Excel, SCADA systems, and HachWIMS, valid driver's license, ability to lift 50 pounds, and PA water license within three years.
Microsoft Word, Microsoft Excel, SCADA, HachWIMS
1w
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RN Case Manager - Utilization Review (Temple Hospital Jeanes Campus)
Philadelphia, Pennsylvania, United States
HybridFull Time
2+ YOEActive PA or multi-state RN license, BSN required, minimum 2 years clinical nursing experience preferred; experience with utilization review/InterQual/MCG and Medicare/Medicaid guidelines; strong clinical judgment and communication.
InterQual, MCG
3mo
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Utilization Management Medical Director - Medical Oncology - Remote anywhere in US
Houston or Chicago or Atlanta or Phoenix or Los Angeles or Saint Louis or San Diego or Dallas or Philadelphia or Seattle
$249k-$373k/yr RemoteFull Time
5+ YOEMD or DO with current medical license; Board Certification in Oncology; 5+ years clinical experience in oncology; NCCN guideline experience; able to support utilization review and case/disease management.
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