Utilization Review Jobs in USA

SummaryReviews and evaluates medical or behavioral eligibility regarding benefits and clinical criteria by applying clinical expertise administrative policies and established clinical criteria to service requests. Utilizes clinical proficiency and claims knowledge/analysis to assess plan implement c...

We anticipate the application window for this opening will close on - 16 Jan 2026At Medtronic you can begin a life-long career of exploration and innovation while helping champion healthcare access and equity for all. Youll lead with purpose breaking down barriers to innovation in a more connected c...

We anticipate the application window for this opening will close on - 2 Jan 2026At Medtronic you can begin a life-long career of exploration and innovation while helping champion healthcare access and equity for all. Youll lead with purpose breaking down barriers to innovation in a more connected co...

Registered Nurse Looking for Utilization Management AND Education experience.Medical Management Educator within Utilization ManagementThis is a hybrid position. The role includes being an Epic Credentialed Trainer from March - October 2026 returning to the Utilization Management team upon Epic imple...

Job DescriptionJOB TITLEUtilization Review NurseREPORTS TOUtilization Review ManagerSTATUSFT ExemptWAGE RANGEGrade 20 (2024)DEPARTMENTUtilization ManagementWORK LOCATIONRemote (occasional travel as required)POSITION PURPOSEThe Utilization Management Nurse is responsible for evaluating clinical servi...

Primary Location: Peace - LouisvilleAddress: 2020 Newburg Rd. Louisville KY 40205 Shift: First Shift (United States of America)Job Description Summary: UofL Health is a fully integrated regional academic health system with five hospitals four medical centers nearly 200 physician practice loc...

Primary Location: Peace - LouisvilleAddress: 2020 Newburg Rd. Louisville KY 40205 Shift: First Shift (United States of America)Job Description Summary: UofL Health is a fully integrated regional academic health system with five hospitals four medical centers nearly 200 physician practice loc...

Job Title: RN Case Manager / Utilization Review / Clinical Documentation Improvement (CDI) Location: Syracuse NY Contract Duration: 13 Weeks Pay: $56$65/hour License: Registered Nurse (RN)Job Summary:Navitas Healthcare LLC is seeking a skilled RN Case Manager with experience in Utilization Review a...

DescriptionPosition SummaryResidential Colleges seeks focused creative and team-oriented candidates to collaborate with residential faculty in program planning and mentoring undergraduates. The program coordinator is part of Residential Colleges within the Provosts Office of Undergraduate Education...

HealthFitness a Trustmark company is a proven leader in providing fitness solutions that engage and connect people both on-site and online to create a strong community of health. Our work focuses on creating meaningful connections with each of our participants to help them move forward. We foster ea...

The Nurse Program Coordinator will be responsible for coordinating the Sickle Cell Disease Community-Based Services and Support (SCD-CBSS) program in the Family Services Department for the Lehigh/Capital Region which includes 13 counties in Pennsylvania. The Nurse Program Coordinator will implement...

Description90% FTE Monday - Friday day shift. No weekends holidays or on-call responsibilities. You will be working at University Hospital in Madison WI.Be part of something remarkableJoin the #1 hospital in Wisconsin!We are seeking a Clinical Program Coordinator - Registered Nurse (RN)in the Ambula...

DescriptionThe Program Coordinator is responsible for overseeing the operational and financial management of the Physical Medicine and Rehabilitation (PM&R) Residency Program with oversight and direction from the PM&R Program Director combining strong initiative and independent judgment to coordina...

HealthFitness a Trustmark company is a proven leader in providing fitness solutions that engage and connect people both on-site and online to create a strong community of health. Our work focuses on creating meaningful connections with each of our participants to help them move forward. We foster ea...

DescriptionPosition SummaryResidential Colleges seeks focused creative and team-oriented candidates to collaborate with residential faculty in program planning and mentoring undergraduates while spearheading the implementation of student leadership initiatives. The senior program coordinator will im...

Our CompanyResCare Community LivingOverviewOur operational team members focus on efficiently meeting the needs of our clients across various lines of business. If your passion is to ensure quality care to help our clients live their best life we encourage you to apply today!ResponsibilitiesEnsures c...

HealthFitness a Trustmark company is a proven leader in providing fitness solutions that engage and connect people both on-site and online to create a strong community of health. Our work focuses on creating meaningful connections with each of our participants to help them move forward. We foster ea...

ABOUT MARINHEALTHAre you looking for a place where you are empowered to bring innovation to reality Join MarinHealth an integrated independent healthcare system with deep roots throughout the North Bay. With a world-class physician and clinical team an affiliation with UCSF Health an ever-expanding...

DescriptionJob Title: Outpatient CoordinatorJob Type: Fulltime Non ExemptSchedule:Your experience mattersLifepoint Behavioral Health is part ofLifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-bei...

DescriptionJob Title: Outpatient CoordinatorJob Type: Fulltime Non ExemptSchedule:Your experience mattersLifepoint Behavioral Health is part ofLifepoint Health a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-bei...