Jobs 1 - 20 out of 59 for Utilization Review Specialist

Top Companies Hiring for Utilization Review Specialist (Page 1 of 3)

Email me jobs like this

Utilization Review Specialist jobs

Join 584,000+ professionals using Career.io alerts.

By clicking the button, you accept our Terms of use and Privacy Policy

Get new jobs by email

Email me jobs like this

Utilization Review Specialist jobs

Join 584,000+ professionals using Career.io alerts.

By clicking the button, you accept our Terms of use and Privacy Policy

ADDICTION AND MENTAL HEALTH SERVICES
Utilization Review Specialist
37923, Knoxville, TN, US
Onsite
Full-time
2 days ago
The Utilization Review Specialist plays a critical role in ensuring that healthcare services provided to patients are medically necessary, efficient, and compliant with regulatory standards. This position involves thorough evaluation of patient records, treatment plans, and clinical data to determin...
Save Job
Verida
Utilization Review Specialist
Villa Rica, GA, US
Onsite
Full-time
2 days ago
Review member transportation requests that are over the contractual mileage guidelines, make approval/denial determinations for transportation requests, process subscription/standing order transportation requests, investigate provider complaints, and complete departmental reports.
Save Job
Sunshine Behavioral Health
Utilization Review Specialist
Washington, US
Onsite
Full-time
4 days ago
The Utilization Review Coordinator is responsible for communicating substance abuse and mental health clinical information to managed care/insurance companies to obtain authorization for treatment services. Responsibilities include completing assessments and pre-certifications, demonstrating underst...
Save Job
Munson Healthcare
Utilization Review Specialist (RN)
Traverse City, MI, US
Hybrid
Full-time
3 days ago
The Utilization Review Specialist (RN) is responsible for ensuring appropriate utilization of healthcare services across the continuum of care. This role evaluates patient admissions, continued stays, and transitions of care to ensure compliance with regulatory requirements, payer guidelines, and ev...
Save Job
RECAP INC
Utilization Review Specialist
Middletown, NY, US
Onsite
Full-time
$27–$34/hour
8 days ago
As a Utilization Review Specialist, you will ensure that clinical services are medically necessary, appropriately authorized, and compliant with all regulatory and payer requirements. Responsibilities include obtaining authorizations from Medicaid Managed Care Organizations, conducting reviews of cl...
Save Job
Treatment Center Management LLC
Remote: Utilization Review Specialist
United States
Remote
Full-time
5 days ago
Support utilization management activities including medical necessity reviews, clinical documentation, and patient status determination. Perform utilization review for inpatient and/or outpatient services, maintain knowledge of payer requirements, and assist with appeals and denials management.
Save Job
Indiana Hemophilia & Thrombosis Center
Utilization Review Specialist
Indianapolis, IN, US
Onsite
Full-time
9 days ago
Manage prior authorizations, medical necessity reviews, and payer-related requirements for specialty medications. Collaborate with prescribers, pharmacists, and clinic staff to facilitate timely access to medications while ensuring compliance with insurance guidelines. Conduct utilization review act...
Save Job
ABHS
Utilization Review Specialist
Evesham, NJ, US
Onsite
Full-time
10 days ago
The Utilization Review Specialist processes all insurance authorizations for partial hospitalization programs, intensive outpatient programs and outpatient programs across business entities to ensure timely and appropriate services for clientele. Responsibilities include handling the continuum of th...
Save Job
Copper-Springs-1
Utilization Review Specialist
85297, Gilbert, AZ, US
Onsite
Full-time
10 days ago
Facilitates clinical reviews for patient admissions and continued stays, analyzes patient records for appropriateness of admission and treatment, advocates for patients with substance use disorders, certifies insurance benefits, completes pre-certifications, communicates with interdisciplinary teams...
Save Job
Ensemble-Health-Partners
Sr. Virtual Utilization Review Specialist
45241, Cincinnati, OH, US
10 days ago
Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point so...
Save Job
ADDICTION AND MENTAL HEALTH SERVICES
Utilization Review Specialist
Lucedale, MS, US
16 days ago
The Director of Utilization Review oversees the utilization management processes to ensure high-quality, cost-effective healthcare services. Responsibilities include developing strategies for resource optimization, leading a multidisciplinary team for clinical evaluations, managing case reviews, and...
Save Job
MARYHAVEN,INC
Utilization Review Specialist (LPCC, LSW, LCDC III or RN)
43207, Obetz, OH, US
Onsite
Full-time
4 days ago
The Utilization Review Specialist coordinates the design, development, implementation, and monitoring of the organization’s Benefits and utilization review functions. Manages daily operations, supervises staff performing benefit enrollments and utilization management activities, and serves as the in...
Save Job
TEKsystems
Utilization Review Specialist
75001, Addison, TX, US
Hybrid
Full-time
$70k–$100k/year
18 days ago
Perform utilization review activities for surgical patients and procedures, review clinical documentation for medical necessity, collaborate with physicians and case management teams, ensure compliance with payer guidelines, and maintain accurate documentation.
Save Job
McLaren Health Care
Utilization Review Specialist Registered Nurse - Behavioral Health
Bay City, MI, US
10 days ago
Department: Behavioral Health Daily Work Times: 7:00am - 3:00pm Shift: Variable Hours Per Pay Period: 0 Position Summary: In conjunction with the admitting/attending physician, the UR Specialist RN assists in determining the appropriate admission status based on the regulatory and reimbursement re...
Save Job
MARYHAVEN INC
Utilization Review Specialist (LPCC, LSW, LCDC III or RN)
43207, Columbus, OH, US
Onsite
Full-time
8 days ago
The Utilization Review Specialist coordinates the design, development, implementation, and monitoring of the organization’s Benefits and utilization review functions. Manages daily operations, supervises staff performing benefit enrollments and utilization management activities, and serves as the in...
Save Job
Innovative Hematology, Inc.
Utilization Review Specialist
Indianapolis, IN, US
23 days ago
About IHTC At the Innovative Hematology (IHI), we offer a future where people with rare blood disorders flourish. Our experts provide the highest quality comprehensive services and holistic care to patients with bleeding, clotting and other hematologic disorders, and to their families. What You Wi...
Save Job
The Florida House
Utilization Review Specialist (Remote)
United States
Remote
23 days ago
Responsible for managing all clinical authorization processes to ensure timely, accurate, and compliant communication with insurance payers. This role supports patient access to treatment by securing initial and continued-stay authorizations, preventing avoidable denials, and collaborating with clin...
Save Job
Clean Recovery Centers
Utilization Review Specialist (Tampa)
33612, Tampa, FL, US
Onsite
Full-time
24 days ago
The URS is responsible for creating and managing the flow of revenue for each client through liaison with insurance companies. Responsibilities include establishing files on incoming clients, maintaining authorization for reimbursement, reviewing medical necessities, calling insurance companies for ...
Save Job
The-Florida-House
Utilization Review Specialist (Remote)
United States
Remote
Contract
24 days ago
Responsible for managing all clinical authorization processes to ensure timely, accurate, and compliant communication with insurance payers. This role supports patient access to treatment by securing initial and continued-stay authorizations, preventing avoidable denials, and collaborating with clin...
Save Job
The-Florida-House
Utilization Review Specialist (Remote)
33441, Deerfield Beach, FL, US
Remote
Full-time
24 days ago
Responsible for managing all clinical authorization processes to ensure timely, accurate, and compliant communication with insurance payers. This role supports patient access to treatment by securing initial and continued-stay authorizations, preventing avoidable denials, and collaborating with clin...
Save Job

Get new jobs by email

Jobs 1 - 20 out of 59 for Utilization Review Specialist

Top Companies Hiring for Utilization Review Specialist (Page 1 of 3)

Email me jobs like this

Email me jobs like this

People also searched:

Our Company

Career Guides

Career Advice

Support