• Group Utilization Review Director

    Tenet Healthcare (Detroit, MI)
    Group Utilization Review Director - 2506000536 Description : The Detroit Medical Center (DMC) is a nationally recognized health care system that serves patients ... diverse employers in Southeast Michigan. Summary Description SUMMARY: The Group Director, Utilization Review will perform the functions necessary to support and… more
    Tenet Healthcare (04/20/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Bronx, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational ... York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency of… more
    New York State Civil Service (04/05/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR II Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/2784979) Apply  UTILIZATION REVIEW NURSE ... administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of the… more
    The County of Los Angeles (03/30/25)
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  • Utilization Review Specialist - RN

    Rochester Regional Health (Rochester, NY)
    …Tuition & Loan Assistance + Employee Referral Program + Free Parking Job Title: Utilization Review RN Department: Utilization Review Location: Rochester ... Per Week: Full Time/40 hours Schedule: Days (8am-4:30pm or 8:30am-5pm) SUMMARY: The Utilization Review Specialist actively participates in the utilization more
    Rochester Regional Health (04/26/25)
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  • Director of Utilization Review

    BriteLife Recovery (Englewood, NJ)
    What you will be doing? The Director of Utilization Review is responsible for overseeing all utilization review activities to ensure that clients receive ... of care for each client. This individual leads a team of utilization review specialists and works closely with clinical, admissions, and billing departments to… more
    BriteLife Recovery (04/24/25)
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  • Licensed Practical Nurse (LPN)…

    The Arora Group (Bethesda, MD)
    Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate, perform and complete assigned duties in providing care to… more
    The Arora Group (02/20/25)
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  • Utilization Review Nurse (On-site)

    Beth Israel Lahey Health (Burlington, MA)
    …difference in people's lives.** In conjunction with the admitting/attending physician, the Utilization Review RN assists in determining the appropriate admission ... of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure criteria for… more
    Beth Israel Lahey Health (02/14/25)
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  • Case Manager Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in Burlington ... Nurse (RN) Case Manager for Hospital at Home Care Transitions coordinates utilization review , discharge planning and monitors quality assurance for Lahey… more
    Beth Israel Lahey Health (04/16/25)
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  • Utilization Review Nurse (RN)

    Matrix Providers (Aurora, CO)
    Utilization Review Nurse (RN) Location: Aurora, CO, United States Healthcare Provider Type : Nursing START YOUR APPLICATION ... ratios and fair, reliable schedules. Matrix Providers is hiring a Utilization Review Nurse (RN) to join our team of talented professionals who… more
    Matrix Providers (04/29/25)
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  • System Utilization Management SUM…

    Alameda Health System (Oakland, CA)
    System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day + ... Nursing + Req #:41907-31045 + FTE:1 + Posted:Today **Summary** **SUMMARY:** The System Utilization Management [SUM] Utilization Review RN is responsible for… more
    Alameda Health System (04/29/25)
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  • Utilization Review Medical Director

    Intermountain Health (Las Vegas, NV)
    …1-3 are a must in order to be considered for the position.** Performs medical review activities pertaining to utilization review , claims review , quality ... with MG clinicians, Affiliate Network PCPs and Specialists in the community, utilization management, care management, claims, network management, and finance. As the… more
    Intermountain Health (03/04/25)
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  • Utilization Review Tech I - ROX…

    Prime Healthcare (Philadelphia, PA)
    …Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech ... essentially works to coordinate the utilization review and appeals process as part of the denial...appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating… more
    Prime Healthcare (04/25/25)
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  • Utilization Review Tech II - Social…

    Prime Healthcare (Passaic, NJ)
    …Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC\_KnowYourRights\_screen\_reader\_10\_20.pdf Responsibilities The Utilization review tech ... essentially works to coordinate the utilization review and appeals process as part of the denial...appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating… more
    Prime Healthcare (04/18/25)
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  • Utilization Review Specialist

    Emory Healthcare/Emory University (Duluth, GA)
    …mentorship, _development,_ and leadership programs + And more **Description** The Utilization Review (UR) Specialist is responsible for conducting medical ... the attending physician and/or physician advisor. + The UR Specialist will perform utilization review by completing a timely and comprehensive review of all… more
    Emory Healthcare/Emory University (04/29/25)
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  • RN- Utilization Review Weekender…

    Baptist Memorial (Meridian, MS)
    Overview RN Utilization Review Weekender Job Code: 22818 FLSA Status Job Family: NURSING Job Description Title: RN Utilization Review Weekender Job ... and appropriateness of healthcare services and treatment as prescribed by utilization review standards. The UR Nurse works with providers, insurance companies… more
    Baptist Memorial (04/22/25)
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  • Behavioral Health Utilization Review

    HCA Healthcare (Nashville, TN)
    …**Introduction** Do you have the career opportunities as a Behavioral Health Utilization Review Specialist you want with your current employer? We ... of colleagues. Do you want to work as a Behavioral Health Utilization Review Specialist where your passion for creating positive patient interactions is valued?… more
    HCA Healthcare (04/25/25)
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  • Utilization Review RN Point of Entry

    Trinity Health (Des Moines, IA)
    …(IA), MercyOne Des Moines Join the MercyOne Family! We are looking to hire a Utilization Review RN! Responsible for the review of inpatient and outpatient ... post discharge. + Carries out hospital programs and principles of utilization review in compliance with hospital policies and external regulatory agencies Peer… more
    Trinity Health (04/19/25)
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  • Manager - Utilization Review

    Beth Israel Lahey Health (Plymouth, MA)
    …a job, you're making a difference in people's lives.** Full Time **Job Description:** ** Utilization Review & Denials management manager - Full Time** **Who We ... of Experts and Serve Your Community!** **In your role as a Utilization Review & Denials Management Manager, you will:** + Directs staff performance regarding… more
    Beth Israel Lahey Health (04/29/25)
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  • Behavioral Health Utilization Review

    HCA Healthcare (Nashville, TN)
    …want to join an organization that invests in you as a Behavioral Health Utilization Review Specialist? At Parallon, you come first. HCA Healthcare has committed ... opportunity to make a difference. We are looking for a dedicated Behavioral Health Utilization Review Specialist like you to be a part of our team. **Job Summary… more
    HCA Healthcare (04/25/25)
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  • RN, Utilization Review Flexi

    Chesapeake Regional Healthcare (Chesapeake, VA)
    * Remote in Hampton Roads* Summary The Utilization Review Nurse combines clinical expertise with knowledge of medical appropriateness criteria, and applies ... a facilitator and consultant to the multidisciplinary patient care team. The Utilization Review Nurse is responsible for review of clinical information… more
    Chesapeake Regional Healthcare (02/16/25)
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