Utilization Review Jobs in USA

Your Tomorrow is Here!Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University...

Provides clinical expertise and guidance to Clinical Analysis and appeals team. Acts as the physician advisor for medical necessity appeals and for the Pennsylvania Medical assistance (PAMA) utilization reviews. Acts as a physician resource for the regulatory and revenue cycle denial and appeals pro...

Your Tomorrow is Here!Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University...

Position SummaryThe RN Care Manager is responsible for the coordination of the patients care and services. Promotes quality care using a collaborative process that coordinates monitors and evaluates services according to the needs of patients. Works together with the patient and family care team pay...

Hours:Shift Start Time:VariableShift End Time:VariableAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:Variable start/end day shift 2 weekend shifts per monthWeekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$53.570 - $69.120 - $77...

About the Role:The Supervisor Inpatient Case Management is responsible for leading and overseeing the daily operations of the inpatient case management team in the San Diego market. This role ensures timely compliant and high-quality utilization management care coordination and documentation while s...

DescriptionAbout usLifeMD is a leading digital healthcare company committed to expanding access to virtual care pharmacy services and diagnostics by making them more affordable and convenient for on both treatment and prevention our unique care model is designed to optimize the patient experience a...

Why Charlie HealthMillions of people across the country are navigating mental health conditions substance use disorders and eating disorders but too often theyre met with barriers to care. From limited local options and long wait times to treatment that lacks personalization behavioral healthcare ca...

The Case Manager is a qualified registered nurse with the ability to provide and oversee the care of assigned patients and associated staff in accordance with physician orders and the plan of care per state Practice this role you will report to the Director of Nursing/Director of Patient Care Servi...

Employment Status:Full timeShift:Day/Evening (United States of America)Facility:1906 Belleview Ave SE - RoanokeRequisition Number:R158370 Clinical Coordinator RN - EM Follow Up - Roanoke (Open) How Youll Help Transform Healthcare:This position is full time day hours working three 12-hour sh...

Your Tomorrow is Here!Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University...

Your Tomorrow is Here!Temple University Hospital is a nationally respected teaching hospital on Temple Universitys bustling Health Sciences Center hospital provides a comprehensive array of healthcare services both basic and complex to patients from around the corner across the country and around t...

Coordinates the delivery of nursing services to patients across the organization. Ensures adequate nursing staff through the management of nursing staff resources. Facilitates and coordinates bed assignments within the hospital. Directs and collaborates with appropriate department managers to faci...

Responsible for the daily operations of the department. Directs the daily activities of the patient interviewers and other related staff in support of the patient access / registration function. Prepares reports statistical summaries time studies and quality control audits.EducationHigh School Dip...

Your Tomorrow is Here!Temple Health is a dynamic network of outstanding hospitals specialty centers and physician practices that is advancing the fight against disease pushing the boundaries of medical science and educating future healthcare professionals. Temple Health consists of Temple University...

Job ID: 795816 Position: Pendleton Transition Coordinator Client: DOC Location: 9310 South State Road 67 Pendleton IN 46064 Duration:8 Months Position is on-site Monday thru Friday. The Transition Specialist for Indianas Department of Correction: Division of Youth Services provides oversight to...

Skills: Five (5) years minimum of clinical experience as a Registered Nurse. 5 years of acute inpatient hospital experience Interqual Milliman proficiency EPIC proficiency Experience with Care Coordination Utilization review and discharge planning Computer literacy. Leadership experience. - pref...

Location: San Jose CA Facility: Hospital Start Date: Asap Length: 13 weeks Available Shifts: 08:00 AM to 04:30 PM Role Type: Care Critical PAY RATES: Local: $70/hr. Travel with housing: $53/hr Travel: $28/hr. taxable $1960/wk. non taxable - 28/49 ** Must be 50 miles away from permanent reside...

What Youll Do:Provide Hands-On Care: Assist individuals with daily activities like personal care meal prep transportation housekeeping and laundry all while fostering independence.Create a Safe & Welcoming Environment: Maintain a clean safe space that ensures comfort and support while helping indivi...

The Case Manager (RN) reviews all direct and Emergency Department admissions or observation patients (preferably at the time of admission) for correct status.  In addition they assess patient clinical data for continued stays discharges and plans of care in all patient care units.  This individual w...