- Kelsey-Seybold Clinic (Houston, TX)
- …as assigned to meet changing business needs **Job Title: Utilization Review Specialist (LVN)** **Location: Remote ** **Department:** ** Utilization ... **Responsibilities** The Utilization Review Specialist (LVN) is responsible for conducting medical reviews, benefit verification, and applying criteria to… more
- WellLife Network (Lake Success, NY)
- QA Utilization Review Specialist - QAS043 - Mon-Fri 9AM-5PM Job Details Job Location Corporate Office (Main Office) - Lake Success, NY Remote Type Hybrid ... Education Level Graduate Degree Salary Range $26.44 - $28.85 Hourly QA Utilization Review Specialist About WellLife Network: WellLife Network is a leading… more
- CareFirst (Baltimore, MD)
- …Qualifications** **PURPOSE:** Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent ... and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist , will analyze clinical information,… more
- 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 ... admission and clinical information to ensure medical necessity and compliance of utilization review guidelines. + Obtain initial and continuing authorization for… more
- Fairview Health Services (St. Paul, MN)
- …on a variety of special projects and assume other duties as assigned by the Utilization Review Manager or Supervisor. + Understand and focus on key performance ... M Health Fairview has an immediate opening for a Utilization Management Specialist RN. This is a...**Required** Education: Bachelor's degree in Nursing Experience: 3-5 years Utilization Review or Case Management experience in… more
- Intermountain Health (Murray, UT)
- …regulatory requirements. + Occasional travel to provider locations within Select Health region. ** Utilization Review and Care Management:** + ** Review and ... expertise of a Licensed and Masters Prepared Behavior Health Specialist with Utilization and Care management. This...in behavioral health. + Knowledge of healthcare insurance and utilization review processes. + Excellent communication and… more
- BayCare Health System (Clearwater, FL)
- …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + ... start for up to 6 months, then eligible for remote ) + **On Call:** No **Certifications and Licensures:** +...Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years… more
- St. Luke's University Health Network (Allentown, PA)
- …regardless of a patient's ability to pay for health care. The Surgical Review Specialist prospectively reviews, validates, and audits procedure code assignment ... of cases lost with feedback to respective departments + Conduct concurrent review with utilization review department for post op surgical cases with… more
- AdventHealth (Altamonte Springs, FL)
- …in non-nursing field, must have at least an Associate's Degree in Nursing) . Utilization Review / Utilization Management experience of at least 2 years ... degree in any field of study . Experience in denial management, utilization review , case management, clinical documentation improvement, revenue integrity, or… more
- Ochsner Health (New Orleans, LA)
- …in the delivery of patient care as an RN. Experience in Case Management, Utilization Review and/or Discharge Planning .either in the Acute Care environment or ... Certification in Case Management (CCM) or Certified Professional in Utilization Review , Utilization Management or...work from the following areas are not eligible for remote work position_ _: Colorado, California, Hawaii, Maryland, New… more