Healthcare Clinical Utilization Review Jobs (NOW HIRING)

HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical ... Utilization Review RN Are you an experienced Registered Nurse with Utilization Review experience ...

Utilization Review Physician - New York (Mostly Remote) Vivo HealthStaff is recruiting for a ... Drives direction of the plan related to cost of care, clinical initiatives, and population health ...

Now celebrating 10 years of growth in 2025, Northpoint is a leading behavioral healthcare provider ... Perform verbal/fax clinical review with payer as determined by nursing judgment and/or ...

The Utilization Review Coordinator opportunity is a key member of the Lighthouse Case Management ... LMSW, LCSW, LMFT, LMHC) * Must have 2 years of experience in a psychiatric health care setting ...

Participates in Medicaid Task Force committee through Alaska Native Health Board. Completes Quality ... care coordination. Educate clinical and administrative staffon risk awareness, safety protocols ...

Responsible for working with the Clinical Care Coordinator and Complex Care Manager to facilitate ... to utilization review and discharge planning and payer regulations. MINIMUM EDUCATION AND ...

... direct clinical care, know and believe they can change and improve patient's lives; and when ... Minimum 2 years of experience with utilization review in a health care provider or insurance ...

... clinical recommendations regarding medical necessity for admission and continues stay, screens ... They process payor denials and retro reviews, promote optimal health care outcomes in accordance ...

The Utilization Review Specialist coordinates insurance authorizations for individual therapy and ... care organizations (MCOs) and clinical staff to ensure timely authorizations for mental health and ...

You will work closely with clinical teams and leadership to help ensure appropriate levels of care ... FSA Healthcare and Dependent Care plan options * Generous PTO, sick time, Covid Time, and 6 paid ...

... care organizations (MCOs) and clinical staff to ensure timely authorizations for mental health and ... utilization reviews, determinations, and communications in the electronic medical record (EMR ...

Description The Utilization Review Specialist coordinates insurance authorizations for individual ... care organizations (MCOs) and clinical staff to ensure timely authorizations for mental health and ...

Riverview Regional Medical Center - Gadsden, AL We are seeking an Utilization Review Technician ... Many other amazing benefits Full benefits at Prime Healthcare: #LI-MP1 Employment Status Full Time ...

Job Summary Under the direct supervision of the HIM Manager, monitors utilization of resources ... CCS, CCS-P, CPC, CPC-H) - 3 years relevant experience; minimum 1 year healthcare/clinical ...

** UTILIZATION REVIEW NURSE III - WASHINGTON STATE - PRE-SERVICE CLINICAL UR/UM ** ** PRIOR ... health care team, members, and caregivers to assist in discharge planning, cost of care options ...

Should be familiar with healthcare operations. Experience with the collection and management of data preferred. Familiar with medical terminology, utilization review, and/or medical insurance ...

The Utilization Review Manager will supervise staff supporting Doctors NeuroPsychiatric Hospital ... to healthcare and utilization management. Strong clinical data analysis, research, and ...

** UTILIZATION REVIEW NURSE III - WASHINGTON STATE - PRE-SERVICE CLINICAL UR/UM ** ** PRIOR ... health care team, members, and caregivers to assist in discharge planning, cost of care options ...

** UTILIZATION REVIEW NURSE III - WASHINGTON STATE - PRE-SERVICE CLINICAL UR/UM ** ** PRIOR ... health care team, members, and caregivers to assist in discharge planning, cost of care options ...

... Johns Hopkins Health Plans, you have the opportunity to use your clinical, managed care ... utilization review, and verbal/written communication skills to make a difference in our members ...