• Communications RF On-Board Networks…

    Craig Technologies (Houston, TX)
    Title: Communications RF On-Board Networks Utilization Specialist (CRONUS) Location: Johnson Space Center, TX Clearance: National Agency Check and Inquiries ... Craig Technologies has an opening for a Communications RF On-Board Networks Utilization Specialist (CRONUS) at Johnson Space Center, TX. An individual in this… more
    Craig Technologies (04/21/25)
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  • Utilization Review Specialist (LVN)

    Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
    …teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records and prepare ... care, length of stay, authorizations and denials for patients. The UR Specialist is responsible for contacting external case managers/managed care organizations for… more
    Bakersfield Behavioral Healthcare Hospital (02/19/25)
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  • Physician Utilization Review…

    Hackensack Meridian Health (Hackensack, NJ)
    The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... and Hackensack UMC. These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of… more
    Hackensack Meridian Health (04/22/25)
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  • Full-time Utilization Review…

    St Joseph's Addiction Treatment & Recovery Centers (Saranac Lake, NY)
    …Centers Location: Inpatient Facility - Saranac Lake, NY Position: Full-time Utilization Review Specialist Shift/schedule: Monday-Friday, 8:00am-4:30pm Pay Range: ... and coordinate account card reimbursements, if necessary. + Support behavioral utilization activities, aligning with agency policies to promote optimal client care… more
    St Joseph's Addiction Treatment & Recovery Centers (04/15/25)
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  • Utilization Review Specialist

    Medical Center Hospital (Odessa, TX)
    Position Summary: The Utilization Review Specialist /Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital ... Utilization Review Program and makes appropriate referrals to designated Physician Advisors. Education: Holds a current Texas license as a Registered Nurse. Training… more
    Medical Center Hospital (03/22/25)
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  • Utilization Management Specialist

    Mount Sinai Health System (New York, NY)
    **Job Description** ** Utilization Management Specialist MSH Case Management FT Days** This position is responsible for coordinating requests for clinical ... internal and external to the institution. Position responsibilities will include utilization management support functions for patient admissions and continuing stay.… more
    Mount Sinai Health System (04/16/25)
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  • Utilization Management Specialist

    Penn Medicine (Lancaster, PA)
    …day. Are you living your life's work? Summary: + Position Summary: The Utilization Management Specialist - Denials is responsible for evaluating medical records ... benefit structures and related legal medical issues. + Knowledge of utilization management and quality improvement processes. + Experience working within the… more
    Penn Medicine (05/01/25)
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  • Utilization Management Specialist

    Trinity Health (Stafford Springs, CT)
    …**Shift:** Day Shift **Description:** RN or Social Worker **Position Purpose** The Utilization Management Specialist is responsible for acute care concurrent ... (Medical Records) and Admitting, to provide pertinent data relating to utilization management / clinical resource management issues and questions **Minimum… more
    Trinity Health (04/30/25)
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  • Utilization Review Specialist

    BriteLife Recovery (Englewood, NJ)
    What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at… more
    BriteLife Recovery (04/30/25)
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  • RN Utilization Review Specialist Per…

    HonorHealth (Scottsdale, AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of ... of extended stay, outpatient observation, and inpatient stays and the utilization of ancillary services. Responsible for coordinating and conducting medical… more
    HonorHealth (03/12/25)
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  • Utilization Management Nurse…

    LA Care Health Plan (Los Angeles, CA)
    Utilization Management Nurse Specialist RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: ... support the safety net required to achieve that purpose. Job Summary The Utilization Management Nurse Specialist RN II facilitates, coordinates, and approves… more
    LA Care Health Plan (03/27/25)
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  • Utilization Review (UR) Specialist

    Spectrum Billing Solutions (Skokie, IL)
    …revenue cycle management company for healthcare organizations. We are looking to add a Utilization Review (UR) Specialist to our growing team. The UR ... and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for treatment… more
    Spectrum Billing Solutions (05/07/25)
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  • Specialist (Part-time) - Varied Shifts…

    Penn State Health (Hershey, PA)
    …(MAILTO://###@pennstatehealth.psu.edu) Penn State Health is seeking a dedicated ** Utilization Management Specialist ** to join our team ... family medical or genetic information._ **Union:** SEIU Healthcare Pennsylvania **Position** Specialist (Part-time) - VARIED SHIFTS - Utilization Management… more
    Penn State Health (04/17/25)
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  • Utilization Review Specialist

    Reno Behavioral Healthcare Hospital (Reno, NV)
    The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...of care that may be covered. + Monitors all utilization reports to assure compliance with reporting and turnaround… more
    Reno Behavioral Healthcare Hospital (04/27/25)
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  • Utilization Management Specialist

    Sanford Health (SD)
    …level of care medical necessity reviews within patient's medical records. Performs utilization management (UM) activities in accordance with UM plan to assure ... members of the healthcare team to promote medically necessary resource utilization and achievement of fiscal outcomes when appropriate. Collaborates with physicians… more
    Sanford Health (04/30/25)
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  • Utilization Review Specialist

    Nuvance Health (Danbury, CT)
    *Description* Summary: Required- Registered Nurse ( RN) The purpose of the Utilization Management Nurse is to support the physician, the interdisciplinary team, and ... of care and providing timely and accurate clinical information to payors. Utilization management provides clinically based first level medical necessity reviews by… more
    Nuvance Health (04/23/25)
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  • Provider Relations Specialist

    Sharp HealthCare (San Diego, CA)
    …and employer business practices. **What You Will Do** The Provider Relations Specialist is responsible for the development and maintenance of positive working ... relationships with all partners, by collaborating on complex organizational initiatives across the integrated delivery system. Provides the connection and partnership between the subcontracted providers, subcontracted services and SRS Medical Group (SRSMG).… more
    Sharp HealthCare (04/16/25)
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  • Utilization Review RN

    Catholic Health Initiatives (Omaha, NE)
    **Responsibilities** Are you a skilled and experienced Utilization Review Specialist looking for a rewarding opportunity to impact patient care and optimize ... our patients. **This position offers the flexibility to work remotely with proven Utilization Review experience.** Medical Coding experience is a plus! As our … more
    Catholic Health Initiatives (04/23/25)
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  • Util Mgmt Specialist I

    Covenant Health Inc. (Knoxville, TN)
    Overview Utilization Management Specialist , Revenue Integrity and Utilization Full Time, 80 Hours Per Pay Period, Day Shift Covenant Health Overview: ... named a Forbes "Best Employer" seven times. Position Summary: The Utilization Management Specialist I will perform utilization management functions to… more
    Covenant Health Inc. (03/28/25)
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  • Utilization Rev & Ref Track…

    Queen's Health System (Honolulu, HI)
    RESPONSIBILITIES I. JOB SUMMARY/RESPONSIBILITIES: * Coordinates and maintains the utilization review process for clinical services including medical, surgical and ... Clinics (QEC). * Performs duties and responsibilities in accordance with utilization tracking and prior authorization procedures. * Assists with coordinating and… more
    Queen's Health System (02/20/25)
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