Utilization Review Specialist
Tulsa, OK · On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... We are looking for a Full Time Utilization Review Specialist! The Utilization Review Specialist ...
Tulsa, OK · On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... We are looking for a Full Time Utilization Review Specialist! The Utilization Review Specialist ...
Tulsa, OK · On-site
For over 65 years, Parkside's physicians, therapists, and staff have provided state of the art, ... We are looking for a Full Time Utilization Review Specialist! The Utilization Review Specialist ...
Kingston, PA · On-site
$25 - $35/hr
) As Wyoming Valley Behavioral Health continues to expand, we're excited to add an experienced full-time Utilization Review Representative to our growing Utilization Review department. The person will ...
Kingston, PA · On-site
$25 - $35/hr
) As Wyoming Valley Behavioral Health continues to expand, we're excited to add an experienced full-time Utilization Review Representative to our growing Utilization Review department. The person will ...
Kingston, PA · On-site
$25 - $35/hr
As Wyoming Valley Behavioral Health continues to expand, we're excited to add an experienced full-time Utilization Review Representative to our growing Utilization Review department. The person will ...
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Kingston, PA · On-site
$25 - $35/hr
As Wyoming Valley Behavioral Health continues to expand, we're excited to add an experienced full-time Utilization Review Representative to our growing Utilization Review department. The person will ...
Champaign, IL · On-site
$61K - $71K/yr
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Champaign, IL · On-site
$61K - $71K/yr
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...
Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...
Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...
Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...
Miami, FL · On-site
(1) Full-Time Utilization Reviewer: Monday through Friday 8:30 a.m. - 5:00 p.m. Qualifications : * Clinical Background with 2 years of UR experience * RN (or) Master level Clinician * CPI ...
New
Miami, FL · On-site
(1) Full-Time Utilization Reviewer: Monday through Friday 8:30 a.m. - 5:00 p.m. Qualifications : * Clinical Background with 2 years of UR experience * RN (or) Master level Clinician * CPI ...
New
... for a full-time Utilization Review (UR)/Case Manager to join our behavioral health team. This ... Collaborate with psychiatrists, nursing staff, therapists, social workers, and administration.
... for a full-time Utilization Review (UR)/Case Manager to join our behavioral health team. This ... Collaborate with psychiatrists, nursing staff, therapists, social workers, and administration.
... for a full-time Utilization Review (UR)/Case Manager to join our behavioral health team. This ... Collaborate with psychiatrists, nursing staff, therapists, social workers, and administration.
... for a full-time Utilization Review (UR)/Case Manager to join our behavioral health team. This ... Collaborate with psychiatrists, nursing staff, therapists, social workers, and administration.
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
Responsibilities Full-time Utilization Review Coordinator Opening The Pavilion Behavioral Health System has been the leading provider of behavioral health and addictions treatment for families in ...
... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ... on eligibility according to full-time, part-time or PRN status classification. Education ...
... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ... on eligibility according to full-time, part-time or PRN status classification. Education ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... , LAPC, LPC, LMSW, LCSW, LPN or RN preferred. Education:UNAVAILABLEEmployment Type: FULL_TIME
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... , LAPC, LPC, LMSW, LCSW, LPN or RN preferred. Education:UNAVAILABLEEmployment Type: FULL_TIME
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... , LAPC, LPC, LMSW, LCSW, LPN or RN preferred. Education:UNAVAILABLEEmployment Type: FULL_TIME
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case ... , LAPC, LPC, LMSW, LCSW, LPN or RN preferred. Education:UNAVAILABLEEmployment Type: FULL_TIME
... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ... on eligibility according to full-time, part-time or PRN status classification. Education ...
... physical therapy to speech therapy, a Level III NICU, robust robotic surgery department and a ... on eligibility according to full-time, part-time or PRN status classification. Education ...
Las Vegas, NV · On-site
$41 - $60/hr
- Utilization Review Nurse Position Summary The Utilization Review Nurse is responsible for reviewing patient admissions and ongoing hospital stays to ensure the delivery of medically necessary ...
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Las Vegas, NV · On-site
$41 - $60/hr
- Utilization Review Nurse Position Summary The Utilization Review Nurse is responsible for reviewing patient admissions and ongoing hospital stays to ensure the delivery of medically necessary ...
Manhattan, NY · On-site
$65K - $75K/yr
Director of Utilization Review DEPARTMENT: Clinical LOCATION : George Rosenfield Center for ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
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Manhattan, NY · On-site
$65K - $75K/yr
Director of Utilization Review DEPARTMENT: Clinical LOCATION : George Rosenfield Center for ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
Director of Utilization Review Under the direction of the Director of Utilization Review, the ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
Director of Utilization Review Under the direction of the Director of Utilization Review, the ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
Director of Utilization Review Under the direction of the Director of Utilization Review, the ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
Director of Utilization Review Under the direction of the Director of Utilization Review, the ... Qualified Health Professional (LCSW, LMSW, LMHC, LMFT preferred) CASAC-T required with ability to ...
Utilization Review (UR) Specialist Location ... Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday Friday ...
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Utilization Review (UR) Specialist Location ... Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday Friday ...
Utilization Review (UR) Specialist Location ... Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday ...
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Utilization Review (UR) Specialist Location ... Chadds Ford, Pennsylvania (Hybrid / Remote Eligible) Job Type: Full-Time Schedule: Monday - Friday ...
$15.63 - $19.08
14% of jobs
$21.93 is the 25th percentile. Wages below this are outliers.
$19.08 - $22.53
14% of jobs
$22.53 - $25.98
17% of jobs
The median wage is $27.88 / hr.
$25.98 - $29.44
11% of jobs
$29.44 - $32.89
8% of jobs
$32.89 - $36.34
6% of jobs
$38.93 is the 75th percentile. Wages above this are outliers.
$36.34 - $39.79
7% of jobs
$39.79 - $43.25
7% of jobs
$43.25 - $46.70
5% of jobs
$46.70 - $50.15
5% of jobs
$50.15 - $53.61
5% of jobs
$15
$31
$53
| Aspect | Full Time Utilization Review Therapist | Case Manager |
|---|---|---|
| Credentials | Typically requires a license in therapy or social work, with certifications in utilization review | Requires social work, nursing, or related licensure; certifications vary |
| Work Environment | Healthcare facilities, insurance companies, utilization review departments | Hospitals, community agencies, insurance companies |
| Primary Focus | Assessing medical necessity and reviewing treatment plans for insurance approval | Coordinating patient care, discharge planning, and resource management |
While both roles involve healthcare and insurance processes, Full Time Utilization Review Therapists focus on evaluating treatment necessity, whereas Case Managers coordinate patient care and services. Understanding these differences helps in choosing the right career path or job search focus.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 4 days ago
Parkside provides professional purpose, hope, and healing. As a member of our staff, you will be part of a mission-driven team, dedicated to changing lives and changing communities, one patient at a time.
Parkside Psychiatric Hospital & Outpatient Clinic is a comprehensive mental healthcare system providing acute inpatient care, residential treatment, and outpatient therapy. With a focus on society’s most vulnerable population, Parkside provides world-class mental health services for youth and adults. For over 65 years, Parkside’s physicians, therapists, and staff have provided state of the art, patient-centered care that propels families from hopeful to hope-filled. As a center of excellence, we cultivate talent and provide professional purpose. Together we facilitate healing, one patient at a time.
We are looking for a Full Time Utilization Review Specialist! The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to limit possible recoupment from third party pay sources including Medicare, Medicaid, HMO or private insurance. Coordinates with clinicians, business office and medical records to achieve above goals.
Responsibilities:
• Prepares authorization paperwork, processes requests for authorizations, and reviews requests for accuracy.
• Communicates with clinicians regarding discharge issues relevant to patient’s pay source. Tracks due dates for authorization reviews and alerts clinicians.
• Communicates with clinicians regarding admissions and discharges to various units.
• Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage. Maintains current knowledge of managed care requirements and accurately interprets these requirements to increase authorizations.
• Coordinates/completes the appeal process for authorization denials
• Performs audits of clinical services to ensure compliance with standards of third party pay sources and agency policies.
• Tracks unauthorized services and possible recoupment issues. Looks for possible corrections, trends.
• Maintains a good working relationship within the department and with other departments.
• Documentation meets current standards and policies.
• Maintains fit for duty. Acts in a professional manner and follows all Parkside policies and procedures.
• Orients new staff members to the unit
• Demonstrates the ability to be organized and flexible, acts appropriately in stressful/emergency situations. Able to provide Handle with Care when needed
• Performs other duties as assigned
Benefits include:
We are an Equal Opportunity Employer!