... physicians to ensure accurate documentation of medical necessity. * Refer cases that do not meet ... Utilization Review Physician Advisor after discussions with attending physicians. Who You Are:
... physicians to ensure accurate documentation of medical necessity. * Refer cases that do not meet ... Utilization Review Physician Advisor after discussions with attending physicians. Who You Are:
... physicians to ensure accurate documentation of medical necessity. * Refer cases that do not meet ... Utilization Review Physician Advisor after discussions with attending physicians. Who You Are:
... physicians to ensure accurate documentation of medical necessity. * Refer cases that do not meet ... Utilization Review Physician Advisor after discussions with attending physicians. Who You Are:
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Strong working knowledge of medical procedures, diagnoses, and procedure codes, including ICD-10, ... Collects and analyzes variances from the plan of care and collaborates with physicians and the ...
Utilization Review Nurse
Alpharetta, GA · On-site
Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 ... Review medical records, physician documentation, treatment plans, and diagnostic results to ...
New
Utilization Review Nurse
Alpharetta, GA · On-site
Utilization Review Nurse Location: [City, State / Remote] Employment Type: Full-Time Experience: 2 ... Review medical records, physician documentation, treatment plans, and diagnostic results to ...
New
A strong utilization review professional ensures medical necessity, appropriate level of care ... physician accordingly. · Performs discharge reviews (ISD) of insurance and HMO patient records and ...
Quick apply
A strong utilization review professional ensures medical necessity, appropriate level of care ... physician accordingly. · Performs discharge reviews (ISD) of insurance and HMO patient records and ...
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Utilization Review Specialist
Odessa, TX · On-site
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Utilization Review Specialist
Odessa, TX · On-site
... Physician Advisors. Qualifications: A. Education: Holds a current Texas license as a Registered ... Three years of clinical nursing experience in a general medical/surgical setting or appropriate ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Quick apply
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review
Marlboro, NJ · On-site
Review clinical documentation to ensure it supports medical necessity. * Submit clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Utilization Review Clinician
Augusta, GA · On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... medical records, participating in treatment team meetings, and collaborating with physicians ...
Utilization Review Clinician
Augusta, GA · On-site
Utilization Review Clinician Opportunity Lighthouse Care Center of Augusta has been providing ... medical records, participating in treatment team meetings, and collaborating with physicians ...
Utilization Review Assistant
Odessa, TX · On-site
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing. Unusual Physical Demands ...
Utilization Review Assistant
Odessa, TX · On-site
Familiar with medical terminology, utilization review, community resource a plus. Basic computer skills required. Be able to communicate effectively verbally and in writing. Unusual Physical Demands ...
Utilization Review Nurse
Cooper City, FL · On-site
Conduct comprehensive clinical assessments of medical records to ensure patients are receiving ... d) Screen cases for Physician Advisor review e) Collaborate with insurance companies on ...
Utilization Review Nurse
Cooper City, FL · On-site
Conduct comprehensive clinical assessments of medical records to ensure patients are receiving ... d) Screen cases for Physician Advisor review e) Collaborate with insurance companies on ...
Utilization Review Clinician
Augusta, GA · On-site
... medical records, participating in treatment team meetings, and collaborating with physicians ... utilization review. LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
Utilization Review Clinician
Augusta, GA · On-site
... medical records, participating in treatment team meetings, and collaborating with physicians ... utilization review. LMHC, LMFT, LAPC, LPC, LMSW, LCSW, LPN or RN preferred.
Contacts physicians and primary Nurses for clarification of information as necessary. * Assures ... Knowledge of utilization review processes and medical terminology * Experience working with ...
Quick apply
Contacts physicians and primary Nurses for clarification of information as necessary. * Assures ... Knowledge of utilization review processes and medical terminology * Experience working with ...
Conduct comprehensive clinical assessments of medical records to ensure patients are receiving ... d) Screen cases for Physician Advisor review e) Collaborate with insurance companies on ...
Conduct comprehensive clinical assessments of medical records to ensure patients are receiving ... d) Screen cases for Physician Advisor review e) Collaborate with insurance companies on ...
Entry Level Medical Utilization Review Physician information
See salary details
$41.5K - $66.4K
0% of jobs
$66.4K - $91.3K
1% of jobs
$91.3K - $116.2K
1% of jobs
$116.2K - $141.1K
0% of jobs
$141.1K - $166K
3% of jobs
$166K - $191K
3% of jobs
$191K - $215.9K
6% of jobs
$221.2K is the 25th percentile. Wages below this are outliers.
$215.9K - $240.8K
49% of jobs
$257.9K is the 75th percentile. Wages above this are outliers.
$240.8K - $265.7K
17% of jobs
$265.7K - $290.6K
15% of jobs
$290.6K - $315.5K
5% of jobs
$41.5K
$233.5K
$315.5K
How much do entry level medical utilization review physician jobs pay per year?

Other
Medical, Dental, Vision, Life, Retirement
Posted 22 days ago
Job description
Come work at the best place to give and receive care!
Job Description:
RN Utilization Review
Who We Are:
Elliot Health System's Care Coordination Department, located in Manchester, NH, plays a vital role in ensuring seamless, patient-centered care across the healthcare continuum. Our team is dedicated to care management, discharge planning, and patient advocacy, working closely with providers, social workers, and community resources to enhance patient outcomes. By developing individualized care plans, facilitating smooth transitions between care settings, and offering proactive support, we help patients navigate complex healthcare needs while improving overall access to high-quality, coordinated care.
About the Job:
Under the direction of the Director of Care Coordination, the Utilization Review RN (UR RN) is responsible for ensuring the effective and efficient use of hospital services in alignment with the hospital's utilization review plan.
What You'll Do:
- Complete admission reviews to determine the appropriate level of care.
- Document continued stay reviews to assess the necessity of inpatient care, procedures, and estimated length of stay.
- Communicate and collaborate with payer care managers to prevent denials by ensuring timely clinical reviews.
- Address potential denials proactively, working with physicians and payer representatives to minimize retrospective denials.
- Screen all patients upon admission or the next business day to determine appropriate level of care using medical necessity tools, Medicare Inpatient Only List, and payer requirements.
- Monitor observation status patients to ensure appropriate utilization, and collaborate with admitting physicians if documentation does not support the current level of care.
- Perform concurrent reviews to justify extended stays, working with attending physicians to ensure accurate documentation of medical necessity.
- Refer cases that do not meet admission or continued stay guidelines to the Utilization Review Physician Advisor after discussions with attending physicians.
- Graduate of an accredited nursing program (Bachelor's degree in Nursing required for nurses hired after May 2015 or commitment to obtain within a specified timeframe).
- Minimum of three (3) years of experience in hospital case management or utilization management.
- Active New Hampshire or Compact State RN license required.
- CCM or ACM certification preferred.
- Health, dental, prescription, and vision coverage for full-time & part-time employees
- Short-term, long-term disability, life & pet insurance
- Tuition reimbursement
- 403(b) Retirement savings plans
- Continuous earned time accrual
Work Shift:
8:00-4:30
SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.
About SolutionHealth
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Nashua, NH, US
Year founded
2018