• Utilization Review

    New York State Civil Service (New York, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator , (NY HELPS), Manhattan Psychiatric Center, P26306 Occupational Category ... 10035 Duties Description Manhattan Psychiatric Center is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and… more
    New York State Civil Service (06/12/25)
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  • Case Manager and Utilization Review

    Scottish Rite for Children (Dallas, TX)
    …to giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital Additional Posting ... Performance Improvement and other areas as assigned + Serve on the Utilization Review Committee for the Scottish + Provide feedback that will enhance… more
    Scottish Rite for Children (05/23/25)
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  • Registered Nurse Utilization Review

    LifePoint Health (Louisburg, NC)
    …job field* **Organization:** **Maria Parham Franklin* **Title:** *Registered Nurse Utilization Review Coordinator * **Location:** *NC-Louisburg* **Requisition ... Registered Nurse (RN) Utilization Review Job Type: Full Time | Day Your experience matters At Maria Parham Hospital, we are driven by a profound commitment to… more
    LifePoint Health (05/15/25)
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  • Utilization Review Services…

    HCA Healthcare (Nashville, TN)
    … like you to be a part of our team. **Job Summary and Qualifications** The Utilization Review Coordinator provides clerical support to the Utilization ... Do you want to join an organization that invests in you as a Utilization Review Services Coordinator ? At Parallonr, you come first. HCA Healthcare has… more
    HCA Healthcare (06/05/25)
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  • Utilization Review /Quality…

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: The Utilization Review /Quality Assurance Coordinator is responsible for all compliance related paperwork and ensures all compliance paperwork is ... completed in a timely manor for the Upstate/Syracuse City School District school-based mental health care program. This position helps ensure successful visits by DNV and OMH when they occur. Monitors and maintains performance improvement indicators on a… more
    SUNY Upstate Medical University (06/03/25)
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  • UR Coordinator

    San Antonio Behavioral Health (San Antonio, TX)
    The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital… more
    San Antonio Behavioral Health (03/30/25)
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  • UR Coordinator

    Georgetown Behavioral Health Institute (Georgetown, TX)
    …is a 118 bed inpatient behavioral health hospital and seeking a full-time Outpatient Utilization Review Coordinator . This position is responsible for working ... help patients access the full range of their benefits through the utilization review process. Requirements + Education: Master's Degree in a relevant field (eg,… more
    Georgetown Behavioral Health Institute (03/19/25)
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  • PRN UR Coordinator

    San Antonio Behavioral Health (San Antonio, TX)
    The Utilization Review Coordinator conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Monitors ... of approvals from insurers. Responsible for monitoring adherence to the hospital's utilization review plan to ensure the effective and efficient use of hospital… more
    San Antonio Behavioral Health (05/28/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator , CCS.** -OR- OPTION II: Two (2) ... UTILIZATION REVIEW NURSE SUPERVISOR I Print...In the County of Los Angeles, a Medical Service Coordinator , CCS (https://www.governmentjobs.com/careers/lacounty/classspecs/1065117) determines medical eligibility of children referred… more
    The County of Los Angeles (05/22/25)
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  • Managed Care Coordinator

    Elderwood (Waverly, NY)
    …Insurance Companies + Knowledge of Medicare and Medicaid Managed Care Policies and Utilization Review . Managed Care Coordinator Skills and Competencies + ... Salary $ 20 / $ 22 Overview Managed Care Coordinator Overview Mon-Fri 8am-4pm The Managed Care Coordinator assists and supports the LPN/RN MDS Coordinator more
    Elderwood (06/06/25)
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  • Program Coordinator -(OMH) LIP Washington…

    Comunilife (New York, NY)
    …and maintain Comunilife policies and procedures, quality assurance, utilization review and outreach activities. The Program Coordinator will collaborate with ... Program Coordinator -(OMH) LIP Washington Heights Job Details Job Location...Description Comunilife Inc. is looking to fill a Program Coordinator position for its Life is Precious, Washington Heights… more
    Comunilife (03/18/25)
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  • Case Manager (CM) - Per Diem $2,500 Sign on

    Select Medical (Los Angeles, CA)
    …caseload. + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator , etc., to assure ... allotted timeframe; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate… more
    Select Medical (05/14/25)
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  • Case Manager (CM) - FT - $10k Sign on

    Select Medical (Los Angeles, CA)
    …caseload. + Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator , etc., to assure ... time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate… more
    Select Medical (05/14/25)
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  • Case Manager (RN or MSW)

    Select Medical (Columbus, OH)
    …of same. Coordinates with other departments, ie: Pre-Admissions, Admissions, Patient Accounts, Utilization Review , PPS Coordinator , etc., to assure positive ... time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate… more
    Select Medical (05/10/25)
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  • Care Coordinator - SCMG Utilization

    Sharp HealthCare (San Diego, CA)
    Coordinator , under the direct supervision of the Supervisor, Utilization Management Care Coordinators, prepares referral requests for outpatient services, ... well as the SCMG operation documents as appropriate for approval at the UM Care Coordinator level of review .Appropriately identify claims for review by the… more
    Sharp HealthCare (06/05/25)
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  • Asst Utilization Coordinator

    WMCHealth (Valhalla, NY)
    Asst Utilization Coordinator - Appeals Company: Westchester Medical Center City/State: Valhalla, NY Category: Nursing/Nursing Management Department: Clinical ... Internal Applicant link Job Details: Internal Posting: 02/25/25 to 03/10/25 Assistant Utilization Coordinator Summary: Under general supervision, an incumbent of… more
    WMCHealth (06/03/25)
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  • Utilization Management Coordinator

    Humana (Frankfort, KY)
    …Prior member service or customer service, telephone experience + Experience with Utilization Review and/or Prior Authorization. preferably within a managed care ... our caring community and help us put health first** The UM Administration Coordinator contributes to administration of utilization management for Humana's KY… more
    Humana (06/11/25)
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  • Utilization & Disease Management…

    CenterWell (Topeka, KS)
    …member service or customer service telephone experience desired + Experience with Utilization Review and/or Prior Authorization, preferably within a managed care ... Coordinator - Phone Intake contributes to administration of utilization management. The UM Administration Coordinator performs varied activities… more
    CenterWell (06/10/25)
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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 ... direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one… more
    The County of Los Angeles (03/30/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …as a team member. **Qualifications** **Qualifications** **Required** + **One year** ** Utilization Review or Case Management experience.** **Licenses Required** + ... Criteria, knowledge of ICD-9, DRG's and CPT Codes. + Utilization Review Certification designation. + Knowledge of...its regulations may be referred to the Title IX Coordinator , to the Department of Education, Office for Civil… more
    University of Utah Health (05/30/25)
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