Atlanta, GA · On-site
$3.0K - $3.1K/wk
Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: * Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company ...
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Atlanta, GA · On-site
$3.0K - $3.1K/wk
Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: * Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company ...
Dalton, GA · On-site
Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive ... Proficient in interpreting benefits, contract language and medical policy/medical review criteria
Dalton, GA · On-site
Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive ... Proficient in interpreting benefits, contract language and medical policy/medical review criteria
Atlanta, GA · On-site
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management ... contract expectations. The primary responsibilities of the Nurse Reviewers are listed below. In ...
Atlanta, GA · On-site
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management ... contract expectations. The primary responsibilities of the Nurse Reviewers are listed below. In ...
Atlanta, GA · On-site
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management ... contract expectations. The primary responsibilities of the Nurse Reviewers are listed below. In ...
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Atlanta, GA · On-site
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management ... contract expectations. The primary responsibilities of the Nurse Reviewers are listed below. In ...
Atlanta, GA · On-site
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management ... contract expectations. The primary responsibilities of the Nurse Reviewers are listed below. In ...
Atlanta, GA · On-site
Alliant is recruiting a Hybrid Review Nurse for its Prior Authorization and Utilization Management ... contract expectations. The primary responsibilities of the Nurse Reviewers are listed below. In ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
... review. Hours : Training is conducted from 7:00 AM to 3:30 PM Mountain Time, with standard shift ... Determines contract and benefit eligibility; provides authorization for inpatient admission ...
Atlanta, GA · On-site
$84K - $113K/yr
KEY RESPONSIBILITIES Contract Administration * Draft, review, negotiate, and administer contracts ... Track contract utilization, burn rates, funded amounts, and expiration dates. * Support forecasting ...
Atlanta, GA · On-site
$84K - $113K/yr
KEY RESPONSIBILITIES Contract Administration * Draft, review, negotiate, and administer contracts ... Track contract utilization, burn rates, funded amounts, and expiration dates. * Support forecasting ...
Atlanta, GA · On-site
$84K - $113K/yr
KEY RESPONSIBILITIES Contract Administration * Draft, review, negotiate, and administer contracts ... Track contract utilization, burn rates, funded amounts, and expiration dates. * Support forecasting ...
Atlanta, GA · On-site
$84K - $113K/yr
KEY RESPONSIBILITIES Contract Administration * Draft, review, negotiate, and administer contracts ... Track contract utilization, burn rates, funded amounts, and expiration dates. * Support forecasting ...
... contract language and medical policy/medical review criteria Current, active Compact State license in Nursing (RN). PHYSICAL REQUIREMENTS Prolonged periods of sitting at a desk and working on a ...
... contract language and medical policy/medical review criteria Current, active Compact State license in Nursing (RN). PHYSICAL REQUIREMENTS Prolonged periods of sitting at a desk and working on a ...
Dalton, GA · On-site
JOB PURPOSE The Utilization Management Nurse performs comprehensive clinical reviews of requested ... contract language and medical policy/medical review criteria • Current, active Compact State ...
Dalton, GA · On-site
JOB PURPOSE The Utilization Management Nurse performs comprehensive clinical reviews of requested ... contract language and medical policy/medical review criteria • Current, active Compact State ...
Dalton, GA · On-site
JOB PURPOSE The Utilization Management Nurse performs comprehensive clinical reviews of requested ... contract language and medical policy/medical review criteria • Current, active Compact State ...
Dalton, GA · On-site
JOB PURPOSE The Utilization Management Nurse performs comprehensive clinical reviews of requested ... contract language and medical policy/medical review criteria • Current, active Compact State ...
Responsible for the performance of Utilization Review services, including pre-admission ... Supply employer/adjuster/insurer with periodic reports agreed to in original contract, but not less ...
Responsible for the performance of Utilization Review services, including pre-admission ... Supply employer/adjuster/insurer with periodic reports agreed to in original contract, but not less ...
Atlanta, GA · On-site
Responsible for the performance of Utilization Review services, including pre-admission ... contract, but not less than biweekly. • Provides input on the performance of support staff to ...
Atlanta, GA · On-site
Responsible for the performance of Utilization Review services, including pre-admission ... contract, but not less than biweekly. • Provides input on the performance of support staff to ...
Responsible for the performance of Utilization Review services, including pre-admission ... Supply employer/adjuster/insurer with periodic reports agreed to in original contract, but not less ...
Responsible for the performance of Utilization Review services, including pre-admission ... Supply employer/adjuster/insurer with periodic reports agreed to in original contract, but not less ...
Atlanta, GA · On-site
$44.14/hr
Performs an admission utilization review upon admission. * Assesses discharge planning needs and ... Remains knowledgeable of contract benefits and current, relevant state and Federal regulations ...
Atlanta, GA · On-site
$44.14/hr
Performs an admission utilization review upon admission. * Assesses discharge planning needs and ... Remains knowledgeable of contract benefits and current, relevant state and Federal regulations ...
To thrive in Contract Utilization Review, you need a solid understanding of medical terminology, insurance policies, and contract compliance, often supported by a healthcare-related degree or certification in utilization management. Familiarity with utilization review software, electronic medical records (EMR), and knowledge of regulatory standards such as CMS guidelines is essential. Strong analytical thinking, attention to detail, and effective communication skills are crucial for collaborating with care teams and insurers. These abilities ensure reviews are accurate, contracts are properly administered, and patient care meets organizational and payer requirements.
A typical day in Contract Utilization Review involves reviewing patient medical records, ensuring adherence to payer contracts and regulatory standards, and communicating with healthcare providers to validate medical necessity of services. Professionals in this role often collaborate with clinical staff, case managers, and insurance representatives to resolve discrepancies or authorization issues. The work is detail-oriented and deadline-driven, making organizational skills vital. This dynamic position offers significant opportunities to learn more about healthcare regulations and may serve as a stepping stone toward more advanced roles in healthcare administration or compliance.
A Contract Utilization Review job involves analyzing and evaluating the usage of contracts to ensure compliance, cost-effectiveness, and efficiency. Professionals in this role review contract terms, monitor vendor performance, and assess utilization data to optimize contract value. They may work in industries such as healthcare, government, or procurement, ensuring that agreements are being properly executed. The goal is to identify areas for improvement, reduce waste, and enhance operational efficiency.
Job title: Utilization Review
Shift: 09:30 AM to 08:00 PM
13 weeks contract
Description:
LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.
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Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we're 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.
Recruiting and staffing services
1,001 - 5,000 Employees
Herndon, VA, US
2000
