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Hourly Weekend Utilization Review Jobs in Arizona

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Weekend availability is required; all applicants must be able to work at least one weekend day ...

Next Move Healthcare

RN, Utilization Review

Tuba City, AZ · On-site

$2.7K/wk

RN, Utilization Review Care Career is looking for Utilization Review RN's to fulfill an assignment in Tuba City, Arizona. Gross Pay: $2,772 Hourly Rate: $32 Weekly Stipend: $1,472 Shift: 5x8 Hour Day ...

Mission Hospital

RN - Utilization Review

Tuba City, AZ · On-site

$2.5K/wk

Utilization Review and Clinical Evaluation : * Review patient medical records, treatment plans, and clinical data to assess the appropriateness of the care being provided and the necessity for ...

ICONMA

Utilization Review RN

Tuba City, AZ · On-site

Utilization Review RN Our client, a Healthcare company, is looking for a Utilization Review RN for their Tuba City, AZ location. Responsibilities: The Utilization Review (UR) Nurse ensures that ...

Meda Health, LLC

RN - Utilization Review

Tuba City, AZ · On-site

$2.5K/wk

Details Client Name Tuba City Regional Healthcare Job Type Travel Offering Nursing Profession RN Specialty Utilization Review Job ID 18890329 Job Title RN - Utilization Review Weekly Pay $2552.28 ...

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Hourly Weekend Utilization Review information

What is the difference between Hourly Weekend Utilization Review vs Medical Billing Specialist?

AspectHourly Weekend Utilization ReviewMedical Billing Specialist
CredentialsTypically requires healthcare-related certifications, such as RHIT or RHIARequires coding certifications like CPC or CCS
Work EnvironmentHealthcare facilities, insurance companies, or utilization review organizations, often during weekendsMedical offices, billing companies, or hospitals, primarily weekdays
Job FocusAssessing patient care and resource utilization during weekendsProcessing insurance claims, coding, and billing

Hourly Weekend Utilization Review involves evaluating patient care and resource use during weekends, often requiring healthcare certifications. In contrast, Medical Billing Specialists focus on coding and billing processes, mainly during weekdays. Both roles are essential in healthcare operations but differ in focus, credentials, and work hours.

What are the most commonly searched types of Weekend Utilization Review jobs in Arizona? The most popular types of Weekend Utilization Review jobs in Arizona are:
Hourly Weekend Utilization Review jobs near you

Utilization Review Nurse

Oscar Health

Tempe, AZ • Remote

$35 - $45.94/hr

Full-time

Re-posted 24 days ago

Oscar Health rating

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

251st of 301 rated insurance

Job description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

You will report into the Supervisor, Utilization Review.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines)
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
  • Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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