Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ... Bachelor's Degree in related field * 2+ years of experience in UM, UR, pre-authorization ...
Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ... Bachelor's Degree in related field * 2+ years of experience in UM, UR, pre-authorization ...
VP of Utilization Review
Franklin, TN · On-site
$120 - $180/hr
Overview The Vice President of Utilization Review (VP of UR) provides strategic and operational ... Oversees authorization management, concurrent review processes, denial prevention strategies ...
New
VP of Utilization Review
Franklin, TN · On-site
$120 - $180/hr
Overview The Vice President of Utilization Review (VP of UR) provides strategic and operational ... Oversees authorization management, concurrent review processes, denial prevention strategies ...
New
VP of Utilization Review
Franklin, TN · On-site +1
Position Summary The Vice President of Utilization Review (VP of UR) provides strategic and ... Oversees authorization management, concurrent review processes, denial prevention strategies ...
VP of Utilization Review
Franklin, TN · On-site +1
Position Summary The Vice President of Utilization Review (VP of UR) provides strategic and ... Oversees authorization management, concurrent review processes, denial prevention strategies ...
Coordinator-Authorization
Memphis, TN · On-site
$16.50 - $20.50/hr
Overview Job Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist ...
Coordinator-Authorization
Memphis, TN · On-site
$16.50 - $20.50/hr
Overview Job Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist ...
Coordinator-Authorization
Memphis, TN · On-site
$19.25 - $24/hr
Job Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist ...
Coordinator-Authorization
Memphis, TN · On-site
$19.25 - $24/hr
Job Summary The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist ...
Coordinator-Authorization
Memphis, TN · On-site
$16.50 - $20.50/hr
Job Posting The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist ...
New
Coordinator-Authorization
Memphis, TN · On-site
$16.50 - $20.50/hr
Job Posting The Authorization Coordinator is responsible for facilitating information documentation and transmission vital to the effectiveness of utilization review and supporting Baptist ...
New
Supervisory Acquisition & Utilization Specialist (Contract Liaison)
Johnson City, TN · On-site +1
$89K - $116K/yr
Establishes, expedites, and reviews the micro-purchase orders and consolidation of all procurement ... Not Authorized Critical Skills Incentive (CSI): Not Approved Requirements Help Conditions of ...
Supervisory Acquisition & Utilization Specialist (Contract Liaison)
Johnson City, TN · On-site +1
$89K - $116K/yr
Establishes, expedites, and reviews the micro-purchase orders and consolidation of all procurement ... Not Authorized Critical Skills Incentive (CSI): Not Approved Requirements Help Conditions of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
Insurance Authorization Coordinator
$17.75 - $22.25/hr
Insurance Authorization Coordinator- Home Health and Hospice Join Pennant's dynamic insurance ... Experience with utilization review and appeals processes. Skills and Competencies * Superior ...
Quick apply
Insurance Authorization Coordinator
$17.75 - $22.25/hr
Insurance Authorization Coordinator- Home Health and Hospice Join Pennant's dynamic insurance ... Experience with utilization review and appeals processes. Skills and Competencies * Superior ...
Insurance Authorization Coordinator
Nashville, TN · On-site
$17.75 - $22.25/hr
Insurance Authorization Coordinator- Home Health and Hospice Join Pennant's dynamic insurance ... Experience with utilization review and appeals processes. Skills and Competencies * Superior ...
Insurance Authorization Coordinator
Nashville, TN · On-site
$17.75 - $22.25/hr
Insurance Authorization Coordinator- Home Health and Hospice Join Pennant's dynamic insurance ... Experience with utilization review and appeals processes. Skills and Competencies * Superior ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
... authorizations with third-party payers. The UM Coordinator reviews cases for appropriateness of admission, continued stay, and discharge planning while assisting in the promotion and maintenance of ...
Care Management Case Manager
Jackson, TN · On-site
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an ...
Care Management Case Manager
Jackson, TN · On-site
Maintains a working knowledge of care management, care coordination changes, utilization review changes, authorization changes, contract changes, regulatory requirements, etc.; serves as an ...
Experience in utilization review, denial management, or appeals. Experience in a shared services or ... authorization workflows Excellent attention to detail and data accuracy Analytical thinking and ...
Experience in utilization review, denial management, or appeals. Experience in a shared services or ... authorization workflows Excellent attention to detail and data accuracy Analytical thinking and ...
Experience in utilization review, denial management, or appeals. * Experience in a shared services ... Deep understanding of intake and authorization workflows * Excellent attention to detail and data ...
Quick apply
Experience in utilization review, denial management, or appeals. * Experience in a shared services ... Deep understanding of intake and authorization workflows * Excellent attention to detail and data ...
... utilization review, denial management, or appeals. • Experience in a shared services or multi ... intake and authorization workflows • Excellent attention to detail and data accuracy • ...
... utilization review, denial management, or appeals. • Experience in a shared services or multi ... intake and authorization workflows • Excellent attention to detail and data accuracy • ...
... Utilization Review Services (URS) team, Pre-bill Denial Units (PDU), and on Authorization and Medical Necessity Denials. What you will do in this role: * Responsible for setting up and coordinating ...
New
... Utilization Review Services (URS) team, Pre-bill Denial Units (PDU), and on Authorization and Medical Necessity Denials. What you will do in this role: * Responsible for setting up and coordinating ...
New
... Utilization Review Services (URS) team, Pre-bill Denial Units (PDU), and on Authorization and Medical Necessity Denials. What you will do in this role: * Responsible for setting up and coordinating ...
New
... Utilization Review Services (URS) team, Pre-bill Denial Units (PDU), and on Authorization and Medical Necessity Denials. What you will do in this role: * Responsible for setting up and coordinating ...
New
Authorization Utilization Review information
What are the key skills and qualifications needed to thrive as an authorization utilization review specialist?
What are some common challenges faced by professionals in authorization utilization review roles, and how can they be addressed?
What is the difference between Authorization Utilization Review vs Claims Reviewer?
| Aspect | Authorization Utilization Review | Claims Reviewer |
|---|---|---|
| Credentials | Typically requires healthcare or insurance-related certifications, such as RN, CPC, or licensed healthcare professionals | Often requires similar credentials, focusing on insurance policies and claims processing |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Insurance companies, third-party administrators, healthcare organizations |
| Industry Usage | Used to assess medical necessity before approving services | Used to evaluate claims for payment accuracy and compliance |
Authorization Utilization Review and Claims Reviewer roles both involve insurance and healthcare knowledge, but Authorization Utilization Review focuses on pre-authorization of services, while Claims Review centers on post-service claims assessment. Understanding these differences helps clarify career paths and job expectations in healthcare insurance.
What is authorization utilization review?
- Senior Behavioral Health Utilization Review
- Per Diem Chart Review Nurse
- Flexible Cvs Utilization Management Nurse
- Per Diem Utilization Review Nurse
- Evening Utilization Review Nurse
- Remote Medical Record Review Nurse
- Flex Schedule Remote Utilization Review Nurse
- Medicare Review Nurse
- No Experience Utilization Review Nurse
- Utilization Review Rn
- Per Diem Optum Utilization Review
- Utilization Review Case Manager
- Fulltime Cigna Utilization Review Nurse
- Therapy Utilization Review
- Chart Utilization Review
- Insurance Utilization Reviewer
- Temporary Aetna Utilization Review Nurse
- Per Diem Remote Occupational Therapy Utilization Review
- Dental Utilization Review
- Online Utilization Review

Full-time
Medical, Dental, Vision
Re-posted 26 days ago
Job description
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Job Title: Utilization Review RN
Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!
Position Summary:
As the Utilization Review RN, you would be responsible for telephonically reviewing medical information in order to determine medical necessity of continued stay according to review standards.
Hours for this Position: Monday-Friday 8:00am-5:00pm
Advantages of this Opportunity:
- Competitive salary, negotiable based on experience
- Benefits offered, Medical, Dental, and Vision
- Fun and positive work environment
- Weekly deposit options
More Insight of Daily Responsibilities:
- Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized
- Determines medical necessity and length of stay based on the consistent application of CMS criteria
- Assesses and coordinates simple discharge planning
- Identifies quality of care issues
What We Look For:
- RN license in the state of TN
- Bachelor's Degree in related field
- 2+ years of experience in UM, UR, pre-authorization, concurrent review, discharge planning and/or skilled nursing
About Healthcare Support
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Industry
Recruiting and staffing services
Company size
201 - 500 Employees
Headquarters location
Maitland, FL, US
Year founded
2003