Utilization Review Technician III
Ontario, CA · On-site +1
$23.15 - $30.03/hr
Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states ... Employment Type: FULL_TIME
Ontario, CA · On-site +1
$23.15 - $30.03/hr
Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states ... Employment Type: FULL_TIME
Ontario, CA · On-site +1
$23.15 - $30.03/hr
Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states ... Employment Type: FULL_TIME
Long Beach, CA · On-site +1
$84K - $172K/yr
Job Summary Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory ...
Long Beach, CA · On-site +1
$84K - $172K/yr
Job Summary Performs behavioral health utilization reviews, applying evidence-based criteria, and collaborating with physicians to ensure clinically appropriate, cost-effective, and regulatory ...
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering ... Coding/CPC desired Skills/Knowledge/Competencies (Behaviors): * Proficiency in conducting ...
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering ... Coding/CPC desired Skills/Knowledge/Competencies (Behaviors): * Proficiency in conducting ...
Portland, ME · On-site +1
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering ... Coding/CPC desired Skills/Knowledge/Competencies (Behaviors): * Proficiency in conducting ...
Portland, ME · On-site +1
Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering ... Coding/CPC desired Skills/Knowledge/Competencies (Behaviors): * Proficiency in conducting ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to assure ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to assure ...
Arkansas City, AR · Remote
$57K - $79K/yr
... our remote team. In this role, you will provide vital support to individuals navigating mental ... Experience in Utilization Review (UR) and Utilization Management (UM) within behavioral health or ...
Quick apply
Arkansas City, AR · Remote
$57K - $79K/yr
... our remote team. In this role, you will provide vital support to individuals navigating mental ... Experience in Utilization Review (UR) and Utilization Management (UM) within behavioral health or ...
Plano, TX · Remote
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Health Care Insurance Company. * Knowledge of medical terminology and procedures. * Verbal and ...
Plano, TX · Remote
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... Health Care Insurance Company. * Knowledge of medical terminology and procedures. * Verbal and ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to assure ...
This position is fulltime remote. Selected candidate must reside in North Carolina. Some travel for ... in reviewing behavioral healthcare/person-centered plans as part of Utilization Review to assure ...
Troy, MI · Remote
$250K - $250K/yr
This full-time, salaried role functions within a structured, high-volume authorization review queue ... Health and wellness programs * Career development opportunities Remote Opportunities We are ...
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Troy, MI · Remote
$250K - $250K/yr
This full-time, salaried role functions within a structured, high-volume authorization review queue ... Health and wellness programs * Career development opportunities Remote Opportunities We are ...
Troy, MI · On-site +1
$250K - $250K/yr
This full-time, salaried role functions within a structured, high-volume authorization review queue ... Health and wellness programs * Career development opportunities Remote Opportunities We are ...
Troy, MI · On-site +1
$250K - $250K/yr
This full-time, salaried role functions within a structured, high-volume authorization review queue ... Health and wellness programs * Career development opportunities Remote Opportunities We are ...
$63K - $87K/yr
Job Title - Behavioral Health Clinician Job Location - Remote but Must Reside in the state of ... Experience in Utilization Review (UR) and Utilization Management (UM) within behavioral health or ...
$63K - $87K/yr
Job Title - Behavioral Health Clinician Job Location - Remote but Must Reside in the state of ... Experience in Utilization Review (UR) and Utilization Management (UM) within behavioral health or ...
Denver, CO · On-site +1
$93K - $117K/yr
And as the need for world-class mental health care continues to rise, our commitment is stronger ... This position is posted as remote; however, per company policy, candidates residing within a ...
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Denver, CO · On-site +1
$93K - $117K/yr
And as the need for world-class mental health care continues to rise, our commitment is stronger ... This position is posted as remote; however, per company policy, candidates residing within a ...
Austin, TX · Remote
$84K - $118K/yr
Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l ... Assess and coordinate discharge planning needs with healthcare team members. * May prepare ...
Austin, TX · Remote
$84K - $118K/yr
Remote Facility: Ascension Network Services Department: Utilization Management Schedule: Days l ... Assess and coordinate discharge planning needs with healthcare team members. * May prepare ...
Chicago, IL · On-site +1
This is a full-time position - 40 hours per week (Must work M-F each day). Responsibilities ... Comprehensive benefit package including health/dental/vision insurance, profit sharing, and 401k ...
Chicago, IL · On-site +1
This is a full-time position - 40 hours per week (Must work M-F each day). Responsibilities ... Comprehensive benefit package including health/dental/vision insurance, profit sharing, and 401k ...
Arkansas City, AR · Remote
$63K - $87K/yr
... our remote team. In this role, you will provide vital support to individuals navigating mental ... utilization reviews or behavioral health case management. • Ability to handle HIPAA confidential ...
Quick apply
Arkansas City, AR · Remote
$63K - $87K/yr
... our remote team. In this role, you will provide vital support to individuals navigating mental ... utilization reviews or behavioral health case management. • Ability to handle HIPAA confidential ...
Arkansas City, AR · Remote
$63K - $87K/yr
... our remote team. In this role, you will provide vital support to individuals navigating mental ... utilization reviews or behavioral health case management. • Ability to handle HIPAA confidential ...
Quick apply
Arkansas City, AR · Remote
$63K - $87K/yr
... our remote team. In this role, you will provide vital support to individuals navigating mental ... utilization reviews or behavioral health case management. • Ability to handle HIPAA confidential ...
Houston, TX · Remote
$137 - $145/hr
Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease ... Conduct medical necessity reviews and peer-to-peer consultations * Collaborate with care management ...
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Houston, TX · Remote
$137 - $145/hr
Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease ... Conduct medical necessity reviews and peer-to-peer consultations * Collaborate with care management ...
Dallas, TX · Remote
$137 - $145/hr
Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease ... Conduct medical necessity reviews and peer-to-peer consultations * Collaborate with care management ...
Quick apply
Dallas, TX · Remote
$137 - $145/hr
Support Utilization Management (UM), Quality Management (QM), Case Management, and Disease ... Conduct medical necessity reviews and peer-to-peer consultations * Collaborate with care management ...
Owensboro, KY · On-site +1
$115K - $120K/yr
Licensed Clinical Social Worker Kentucky Remote Behavioral Health Role Location: Kentucky Work ... Remote / Telehealth Position Type: Full-Time Pay: $115,000-$120,000 per year with full benefits ...
Owensboro, KY · On-site +1
$115K - $120K/yr
Licensed Clinical Social Worker Kentucky Remote Behavioral Health Role Location: Kentucky Work ... Remote / Telehealth Position Type: Full-Time Pay: $115,000-$120,000 per year with full benefits ...
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...
Quick apply
Rancho Cucamonga, CA · Remote
$30.64 - $45.80/hr
This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: * Identifies the necessity of ... A comprehensive benefits package is available for full-time regular employees and includes Medical ...
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68

$23.15 - $30.03/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 23 days ago
6.3
Based on 269 frontline employees who took The Breakroom Quiz
663rd of 870 rated healthcare providers
Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation's leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
ResponsibilitiesThe Utilization review tech essentially works to coordinate the utilization review and appeals process as part of the denial management initiatives. This position will also serve as a liaison and own the coordination with other UR techs in the team while being responsible for coordinating phone calls, data entry, mailing/faxing appeals and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans and scan all related correspondence to the respective EMR/ tracking tool. Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will also serve as the primary contact and coordinate the work to maintain integrity of tracking government review audits (RAC, MAC, CERT, ADR, Pre/Post Probes, QIO/Medicaid) and other payer audits as assigned. UR tech III will also function as an SME to support the UR tech team and remote counter parts with the specific processes as applicable. The Utilization review tech will further support the department needs for Release of Information through faxing and mailing, discharge coordination or other duties as assigned.
QualificationsPreferred qualifications:
Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $23.15 to $30.03. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Employment StatusFull TimeShiftDaysEqual Employment OpportunityCompany is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Privacy NoticePrivacy Notice for California Applicants: https://www.primehealthcare.com/wp-content/uploads/2024/04/Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdf
Employment Type: FULL_TIMEGet the full story on Breakroom
Sourced by ZipRecruiter
Hospitals
10,000+ Employees
Ontario, CA, US