• Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're working… more
    The County of Los Angeles (08/18/25)
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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 (06/28/25)
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  • Staff Nurse - Utilization Review

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    …and may require up to*Every Other Weekend*coverage/. *_SPECIFIC RESPONSIBILITIES:_* The Utilization Review (UR) Registered Nurse is responsible for evaluating ... evidence-based practice *Quality of Practice*: * Promotes quality through evidence-based utilization review processes and actively contributes to performance… more
    Minnesota Visiting Nurse Agency (09/13/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
    Commonwealth Care Alliance (09/05/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include supervising staff… more
    Minnesota Visiting Nurse Agency (08/08/25)
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  • Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital utilization more
    Community Health Systems (09/03/25)
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  • Registered Nurse - Utilization

    Beth Israel Lahey Health (Boston, MA)
    …lives.** Position Summary: 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 (09/10/25)
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  • Utilization Review Coordinator

    Behavioral Center of Michigan (Warren, MI)
    Under general supervision, the Utilization Review Coordinator provides professional assessment, planning, coordination, implementation and reporting of complex ... clinical data and supports the operations of Samaritan Behavioral Center. The Utilization Review Coordinator reviews the patient's chart and records clinical… more
    Behavioral Center of Michigan (09/11/25)
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  • Utilization Review Technician

    Prime Healthcare (North Las Vegas, NV)
    …and more. For more information, please visitwww.northvistahospital.com. Responsibilities The Utilization review tech essentially works to coordinate the ... utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls,… more
    Prime Healthcare (09/11/25)
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  • ABA Utilization Review (UR)…

    Spectrum Billing Solutions (Skokie, IL)
    …in the most efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist will ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
    Spectrum Billing Solutions (09/01/25)
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  • Utilization Review Tech II

    Prime Healthcare (Passaic, NJ)
    …System" by Truven Health Analytics. For information, visitwww.smh-nj.com. Responsibilities The Utilization review tech essentially works to coordinate the ... utilization review and appeals process as part of the denial management initiatives. Utilization review tech is responsible for coordinating phone calls,… more
    Prime Healthcare (08/26/25)
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  • Utilization Review Specialist

    Emory Healthcare/Emory University (Atlanta, GA)
    …mentorship, _development,_ and leadership programs + And more **Description** The ** Utilization Review (UR) Specialist** is a Registered Nurse responsible ... acute hospital experience or a minimum of two years of previous utilization review experience. + Must have a valid, active unencumbered Registered Nurse license… more
    Emory Healthcare/Emory University (09/13/25)
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  • Utilization Review Technician III

    Prime Healthcare (Ontario, CA)
    …is actively seeking new members to join our corporate team! Responsibilities The Utilization review tech essentially works to coordinate the utilization ... plans and scan all related correspondence to the respective EMR/ tracking tool. Utilization review tech will follow up on all denials while working closely with… more
    Prime Healthcare (08/23/25)
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  • Utilization Review Case Mgr CMC-…

    UTMB Health (Webster, TX)
    Utilization Review Case Mgr CMC- Clear Lake Center **Webster, Texas, United States** **New** Nursing & Care Management UTMB Health Requisition # 2505026 The ... or observation in Community Hospitals and UTMB-TDCJ Hospital. + Performs utilization review procedures by prospectively, concurrently, and retrospectively… more
    UTMB Health (09/14/25)
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  • Utilization Review Clinician

    Monte Nido (Miami, FL)
    …while providing the opportunity for people to realize their healthy selves. ** Utilization Review Clinician** **Monte Nido** **Remote** **Monte Nido has been ... provide comprehensive care within an intimate home setting. We are seeking a Utilization Review Clinician to join our team based Remotely. **This is a Full-Time… more
    Monte Nido (09/06/25)
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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 (07/29/25)
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  • Regional Medical Director, Care Management…

    UPMC (Pittsburgh, PA)
    The Regional Medical Director, CC/DP and Utilization Review , provides clinical and management leadership across multiple hospitals within the region. This role ... managed care organizations, providers, and payers to address benefit coverage, utilization review , and quality assurance. + Promote adherence to URAC standards,… more
    UPMC (07/11/25)
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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 (09/02/25)
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  • Utilization Review Specialist-…

    MetroHealth (Cleveland, OH)
    ** Utilization Review Specialist- Utilization Management** **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **10a-6:30p** ... **Responsible for communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows up on inquiries… more
    MetroHealth (08/20/25)
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  • Utilization Review Clinician…

    Centene Corporation (Springfield, IL)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... or eastern time zone with experience in mental health settings and utilization management / review . * Department: PHCO BH UM supporting IL Meridian Medicaid *… more
    Centene Corporation (08/21/25)
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