494 utilization review case manager jobs at 222 companies in United States
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Utilization Review/Case Manager
Magnolia, Mississippi, United States
OnsiteFull Time
2+ YOETwo years of behavioral health, case management, utilization review, or discharge planning experience; knowledge of behavioral health care levels and medical necessity; communication, organization, computer, and EMR skills.
electronic medical record, InterQual, MCG, CMS, HIPAA
5d
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Utilization Review Case Manager - Partial Hospitalization Program
Annapolis or Bowie or Lanham
$82k-$123k/yr OnsitePart Time
2+ YOEBachelor's degree and two years of utilization review or utilization management experience required. Assesses medical necessity, manages referrals, reviews records, and coordinates with payors.
2w
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Case Manager, RN- Utilization Review
Tampa, Florida, United States
$36/hr RemoteFull Time
3+ YOEFlorida RN license and three years of practicing RN experience required. Utilization management experience preferred. Requires utilization review expertise, medical necessity assessment, payer collaboration, documentation, and Microsoft applications.
InterQual, Electronic Medical Records (EMR), utilization management systems, Microsoft Outlook, Microsoft Teams, Microsoft Word, Microsoft Excel
1mo
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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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Case Manager - Utilization Review
Oxford, North Carolina, United States
OnsiteFull Time
1+ YOEAssociate degree in healthcare or equivalent, 1+ year related experience in utilization review/case management, ability to interpret clinical documentation, strong communication, organizational skills, and knowledge of payer/regulatory requirements; ACM certification preferred.
1mo
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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.
1w
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Case Manager/ Utilization Review Registered Nurse
Athens, Georgia, United States
RemoteFull Time
3+ YOECurrent Georgia RN license and BLS required; nursing graduate with 3–5 years related experience. Requires clinical, analytical, organizational, communication, computer, and utilization review skills.
MCG, InterQual, EPIC, Electronic Medical Record (EMR), Microsoft Word, Microsoft Teams, Microsoft Outlook, Microsoft Excel
1w
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Utilization Review Coordinator
Phoenix, Arizona, United States
OnsiteFull Time
High school diploma or equivalent; 1–2 years of utilization review preferred. Requires analytical, communication, collaboration, case management, authorization, behavioral health, and regulatory knowledge.
Microsoft Office 365, SmartSheets, Kipu, Collaborate MD, Sigmund Electronic Management system
3d
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Utilization Review Coordinator
United States
$55k-$75k/yr RemoteFull Time
2+ YOEBachelor’s degree in healthcare or related field, 2+ years in utilization review, case management, or clinical healthcare, and knowledge of medical terminology, clinical procedures, regulations, and insurance authorization.
Electronic health records (EHR), utilization management software, Employee Assistance Program (EAP), Cognitive Behavioral Therapy (CBT), Voya
3d
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Director, Utilization Review
Lucedale or United States
HybridFull Time
5+ YOEBachelor’s degree in nursing, health administration, or related field; 5+ years in utilization review, case management, or healthcare operations; regulatory, payer, data analysis, and process improvement expertise.
Electronic Health Record (EHR), Employee Assistance Program (EAP), Cognitive Behavioral Therapy (CBT), Voya
2mo
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Utilization Review RN
Portland or Washington or Alaska or California or Montana or New Mexico or Texas
$50-$78/hr HybridPart Time, Full Time
5+ YOEBachelor's degree in nursing, or associate degree with 2+ years related experience; Oregon RN license; five years acute adult medical-surgical, utilization review, or case management experience.
5d
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Utilization Review Specialist
Las Vegas, Nevada, United States
OnsiteFull Time
2+ YOECurrent LPN, RN, clinical license, or master's degree; 2+ years clinical experience including 1+ year in utilization review or case management; Nevada payer knowledge; Microsoft Word and Excel skills.
Microsoft Word, Microsoft Excel
2mo
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Utilization Review Coordinator
Franklin or United States
OnsiteFull Time
0+ YOEHS diploma/GED required, Bachelor's preferred. 0-2 years experience in utilization review, hospital admissions, or registration required. Proficiency with case management systems, strong communication, organization, and critical thinking skills.
case management systems
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
2mo
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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
2mo
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Utilization Review Coordinator
Huber Heights, Ohio, United States
OnsiteFull Time
2+ YOEBachelor's in behavioral health/social work/counseling/nursing/psychology required; 2+ years utilization review and 2+ years case management/discharge planning in hospitals; CCM/ACM preferred; BLS and HWC during orientation; strong documentation and communication skills.
3mo
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RN Utilization Review Case Manager
Granite City, Illinois, United States
$32-$48/hr OnsiteFull Time
5+ YOERN with at least 5 years' acute care or community health experience; licensed nurse; full-time with benefits; hourly pay.
1w
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Utilization Review Nurse
Albany, New York, United States
$77k-$119k/yr OnsiteFull Time
3+ YOERequires New York RN license, associate degree, and 3 years of clinical experience. Utilization or case management experience, MCG criteria knowledge, Medicare requirements, and case management certification are preferred.
MCG, ICD-10
1mo
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Utilization Review Specialist (FLEXI)
Chesapeake, Virginia, United States
$32-$44/hr OnsitePart Time
2+ YOECurrent unrestricted LPN license in Virginia or compact state, 2 years clinical healthcare experience, familiarity with utilization review/case management, strong documentation and communication skills.
3w
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Case Manager - Utilization Review RN
United States
$43-$53/hr OnsiteFull Time
3+ YOEActive Illinois RN license, Associates in Nursing required (BSN preferred), 3+ years acute care experience, 2+ years case management/utilization review preferred, BLS/ACM/CCM/CMAC certifications preferred, InterQual/MCG and EMR experience.
InterQual, MCG, Electronic Medical Records (EMR)
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