Utilization Review Specialist Jobs in USA

Review service plan requests from case managers daily a. Ensure plans are detailed and comprehensive i. Communicate with case managers in writing and by telephone to obtain information provide technical assistance and resolve service plan/ client issues. ii. Review client files for information rel...

Utilization Review SpecialistHYBRID must be able to travel to 3031 NE STEPHENS ST. ROSEBURG OR 97470EMPLOYMENT TYPE- Full-Time ExemptAbout Umpqua HealthAt Umpqua Health were more than a healthcare organizationwere a community-driven Coordinated Care Organization (CCO) dedicated to improving the heal...

Position: Utilization Review SpecialistReq.#: 26-61FTE: Full-time ExemptUnit: UAWDepartment/Location: Utilization ManagementCompensation:$63102.73-$83647.81The Final job offer is based on several factors (internal equity skills education experience and credentials).Attractive Benefits Package: Four...

DescriptionWe are seeking a full-timeCase Review Specialistrole to join our Care Management Team in Columbus Ohio.Salary: $48000 - $50000To learn more about the program please see the information below: SummaryThe Case Review Specialist position serves as a Case Reviewer for the program. This positi...

Wintrust provides community and commercial banking specialty finance and wealth management services through its 16 bank charters and nine non-bank businesses. Wintrust delivers the sophisticated solutions of a large bank while staying true to the relationship-focused personalized service of our comm...

Job Title: Support Quality Review SpecialistLocation: Westminster CO or Dayton OH onsiteBusiness Segment: Field Systems ConstructionElevate Civil Construction Standards as a Support Quality Review Specialist!Ready to empower the global support team as a Support Quality Review Specialist Join Trimble...

Date Posted:Country:United States of AmericaLocation:US-AZ-TUCSON-E Hermans Rd BLDG 801 (External Site)Position Role Type:OnsiteU.S. Citizen U.S. Person or Immigration Status Requirements: The ability to obtain and maintain a U.S. government issued security clearance is required. U.S. citizenship...

Work Location:New York New York United States of AmericaHours:40Pay Details:$97240 - $145600 USDTD is committed to providing fair and equitable compensation opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compen...

Company:MarshDescription:At Marsh Risk we are seeking a Senior Insurance Contract Review Specialist in various locations across the US. This is an opportunity to make a significant impact for clients while delivering cutting-edge insurance contract review expertise at the highest level within the in...

DescriptionWe are seeking a full-timeCase Review Specialistrole to join our Care Management Team in Columbus Ohio.Bachelors degree in human services from an accredited college or university required.2 years of Child Welfare experience required.Salary: $48000 - $50000To learn more about the program p...

Please note- Candidates must have COS-C HCS-O or COQS and HCS-D or BCHH-C in order to be considered there is no flexibility around this requirement.BAYADA Home Health Care has an immediate opening for aFull TimeOASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN...

Utilization Review ManagerReports to: CEOJob Category: Salaried Exempt Full-TimeStarting Salary: $75000-$95000/year (DOE)Job Site: Remote (must reside in Colorado)Job Summary:The Utilization Review Manager is responsible for overseeing utilization review activities to ensure medical necessity regu...

MissionQSAC is a New York City and Long Island based nonprofit that supports children and adults with autism together with their families in achieving greater independence realizing their future potential and contributing to their communities in a meaningful way by offering person-centered services....

Looking for an Opportunity to Make an ImpactAt Leidos we deliver innovative solutions through the efforts of our diverse and talented people who are committed to our customers success. We empower our teams contribute to our communities and operate sustainably. Everything we do is grounded in our com...

We are hiring Utilization Review Analyst Hybrid for one of our clients in Hamilton NJ. Job Description: Review service plan requests from case managers daily Ensure plans are detailed and comprehensive Communicate with case managers in writing and by telephone to obtain information provide te...

Current University of Arkansas System employees including student employees and graduate assistants need to log in to Workday via then access Find Jobs from the Workday search bar to view and apply for open positions. Students at University of Arkansas System will also view open positions and apply...

General Summary:Responsible for supporting the utilization review system including data analysis report writing and program improvement.UR Specialist will develop and maintain a VOD Tracking and Receipt system.UR Specialist will maintain an expert level review of client entitlements and billing auth...

General Summary:Responsible for supporting the utilization review system including data analysis report writing and program improvement.UR Specialist will develop and maintain a VOD Tracking and Receipt system.UR Specialist will maintain an expert level review of client entitlements and billing auth...

Job Title: Registered Nurse (RN) Case Manager / Utilization Review / CDILocation: Syracuse NY Duration: 13 WeeksJob SummaryWe are seeking an experienced Registered Nurse Case Manager with a strong background in Utilization Review and Clinical Documentation Improvement (CDI). The RN will be responsi...

SummaryOversees the accurate processing of claims that have been deferred for medical necessity review. Ensures compliance with nationally recognized standards and local state and federal laws and regulations. Identifies and implements process improvement opportunities.DescriptionWhy should you join...