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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)
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)
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.
1w
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Utilization Review Coordinator
Port St. Lucie, Florida, United States
OnsiteFull Time
2+ YOECoordinate insurance reviews, monitor authorizations, review records, prepare reports and appeals; RN or LPN or equivalent clinician experience, CPR required, 2+ years preferred, knowledge of utilization review and medical terminology.
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.
4w
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Utilization Review Coordinator
West Columbia, South Carolina, United States
OnsiteFull Time
2+ YOEMasters in a recognized mental health field or RN; minimum 2 years psychiatric experience in chart analysis and utilization review; strong oral/written communication; knowledge of external review organizations and payor systems.
2mo
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Utilization Review RN
Springfield, Illinois, United States
$33-$53/hr OnsiteFull Time
3+ YOERN with 3-5 years in acute care/home health/case management; IL license; associate degree; utilization review exp preferred
2w
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Utilization Review Specialist
Lafayette, Indiana, United States
OnsiteFull Time
Bachelor's degree required. Knowledge of clinical criteria and managed care, utilization review experience in psychiatric settings preferred, strong communication and authorization/appeals skills.
1w
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Utilization Review Coordinator
Parsippany, New Jersey, United States
$33/hr OnsiteFull Time
2+ YOEBachelor's required (master's preferred), 2+ years behavioral health or utilization review experience, familiarity with insurance authorization and medical necessity, strong documentation and communication skills.
1w
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Utilization Review Nurse
New Lenox, Illinois, United States
$35-$45/hr HybridFull Time
Current RN licensure, current CPR, knowledge of clinical norms, strong communication and critical thinking; experience in utilization review, case management or hospital nursing preferred.
3mo
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Utilization Review Coordinator
Indianapolis, Indiana, United States
OnsiteTemporary
2+ YOEBachelor’s in Behavioral Health, Social Work, Counseling, Nursing or Psychology; Master’s preferred. 2+ years utilization review and case management in hospital setting; CCM/ACM preferred.
2mo
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Utilization Review Nurse
United States
$35-$46/hr RemoteFull Time
1+ YOE1+ year of utilization review experience; RN license in the US or compact multistate license; ability to obtain additional state licenses; strong experience with Milliman Care Guidelines (MCG).
Milliman Care Guidelines, MCG
2mo
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Utilization Review RN
Springfield, Illinois, United States
$33-$53/hr OnsiteFull Time
3+ YOEAssociates Degree in Nursing; Illinois RN license; 3-5 years acute care/home health/case management experience; experience with utilization review; continuing professional development.
iCIMS, EMR
2mo
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Utilization Review Nurse
Las Vegas, Nevada, United States
$40-$63/hr OnsiteFull Time
5+ YOEActive Nevada RN license, 5+ years acute care nursing, minimum 3 years utilization management experience, experience with InterQual and Milliman criteria, strong chart review and communication skills.
InterQual, Milliman
1mo
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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
3mo
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Utilization Review Nurse
New Orleans, Louisiana, United States
OnsiteFull Time
3+ YOERN licensed in Louisiana with BSN; 3-5 years acute care experience; knowledge of Medicaid/Medicare regulations; experience with utilization review and case management; proficient in MS Office; strong communication and problem-solving skills.
MS Office (Word, Excel, Outlook)
3w
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Utilization Review Manager
Chicago, Illinois, United States
OnsiteFull Time
3+ YOEMaster's degree required, 3+ years utilization review/case management/clinical documentation experience, active LCSW or LCPC preferred, proficiency in EHR and Google Office Suite, strong knowledge of payer authorization and regulatory compliance.
EHR, Google Office Suite
3mo
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Utilization Review Nurse (Medicare)
Spring Valley, New York, United States
$41-$47/hr OnsiteFull Time
2+ YOERN with Medicare experience; 2+ years in utilization review; NY license; BSN preferred.
Medicare guidelines, N/A
1mo
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Utilization Review Nurse
Salt Lake City, Utah, United States
OnsiteFull Time
1+ YOEActive Utah RN license (or obtain within 90 days), 1+ year utilization review or case management experience, knowledge of InterQual and payer systems, BLS preferred, strong communication and critical thinking, ability to work rotating shifts.
InterQual, ICD-9, DRG, CPT
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