Utilization Review Specialist Jobs in USA

Emergency Department Crisis ClinicianBaystate Health a nationally recognized leader in healthcare quality and safety and home to the regions only Level 1 Trauma Center and Pediatric Trauma Center is looking for a full-time Emergency Department Crisis Clinician to join our Baystate Wing ED Crisis Tea...

OverviewVersiti is a fusion of donors scientific curiosity and precision medicine that recognize the gifts of blood and life are precious. We are home to the world-renowned Blood Research Institute we enable life saving gifts from our donors and provide the science behind the medicine through our di...

The Aerospace Corporation is the trusted partner to the nations space programs solving the hardest problems and providing unmatched technical expertise. As the operator of a federally funded research and development center (FFRDC) we are broadly engaged across all aspects of space delivering innovat...

WHO WE ARE & WHAT WE DOTallahassee Memorial Healthcare (TMH) is a private nonprofit community-based healthcare system that provides care to a 22-county region in North Florida and South Georgia. We are a career destination with over 6000 colleagues who reflect the diversity of our community.TMH is t...

Applied Technologies GroupUtility Helicopter FMS Program Support CoordinatorWho We Are: AM Pierce & Associates and Applied Technologies Group (ATG) a wholly owned subsidiary of AM Pierce and Associates is a woman-owned small business providing Engineering & Research Cyber C5ISR Program & Acquisition...

DescriptionSchedule:Salary Range:Your experience matters:At Valley Springs Behavioral Hospital we are committed to empowering and supporting a diverse and determined workforce who can drive quality scalability and significant impact across our hospitals and your role youll support those that are in...

DescriptionSalary Range: $33.22 $44.85Your experience matters:At Valley Springs Behavioral Hospital we are committed to empowering and supporting a diverse and determined workforce who can drive quality scalability and significant impact across our hospitals and your role youll support those that...

OverviewWho We AreBecause health is personal. Thats why Personify Health created the first and only personalized health platformbringing health plan administration holistic wellbeing solutions and comprehensive care navigation together in one place. We serve employers health plans and health systems...

OverviewThe Care Coordinator is a member of the multidisciplinary team that actively facilitates those functions that move a patient through an acute episode of care and links to internal and external resources and the payor community. The Care Coordinator assumes responsibility and leads the proces...

OverviewThe Care Coordinator is a member of the multidisciplinary team that actively facilitates those functions that move a patient through an acute episode of care and links to internal and external resources and the payor community. The Care Coordinator assumes responsibility and leads the proces...

JOB SUMMARYThe RCM Aging Specialist is responsible for follow-up on aged accounts by working insurance A/R aging reports (60/90/120 days) to identify unpaid or underpaid claims and ensure timely accurate reimbursement from insurance companies. This role requires strong payer communication skills eff...

The work we do matters!Hiring Agency:Administrative Services - Agency 65Location: Omaha NEHiring Rate:$26.935Job Posting:JR2026- Foster Care Review Specialist (SOS Temporary) (Open)Applications No Longer Accepted On (If no date is displayed job is posted as open until closed):0Job Description:Are yo...

Fish & Richardson the premier global intellectual property law firm is trusted by the worlds most innovative and influential companies. Fish was established in 1878 and now has more than 400 attorneys and technology specialists in the U.S. Europe and China. Our success is rooted in our creative and...

ID: Shift: Day 5x8-Hour (08:30 - 17:00) Description: Utilization Review Nurse*THIS IS NOT A REMOTE POSITION. It is an in person :5x8 s; M-F; 8:30 5pmNo WeekendsNo CallEDUCATIONGraduate from an accredited school of nursing BSN of two (2) years of Utilization Review experience. EPIC experience is re...

ID: Shift: Day 5x8-Hour (08:00 - 16:30) Description: Utilization Review RNMust have current utilization review experience within the last Start Prefer Local candidates in the DC area60 Mile traveler radius*This position will be working out of the Medstar Georgetown facility starting May 1 2026 Mod...

ID: Shift: Day 5x8-Hour (08:00 - 16:30) Description: Utilization Review RNMust have current utilization review experience within the last Start Prefer Local candidates in the DC area60 Mile traveler radius*This position will be working out of the Medstar Georgetown facility starting May 1 2026 Mod...

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...

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 organization were a community-driven Coordinated Care Organization (CCO) dedicated to improving the hea...

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...