Care Review Nurse
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Quick apply
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Columbus, OH · On-site
Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Marlboro, NJ · On-site
Obtain initial and concurrent insurance authorizations for all levels of care. * Review clinical ... Participate in utilization review meetings and case conferences. * Generate reports on ...
Arcata, CA · On-site
The Utilization Review Coordinator is responsible for facilitating, coordinating, integrating and ... Communicates with insurance representatives and third party payers to ensure appropriate ...
Arcata, CA · On-site
The Utilization Review Coordinator is responsible for facilitating, coordinating, integrating and ... Communicates with insurance representatives and third party payers to ensure appropriate ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Tampa, FL · On-site
$59K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Saint Louis, MO · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Saint Louis, MO · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Wayne, PA · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Wayne, PA · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Miami, FL · On-site
... insurance company reimbursement policies. Performs utilization review and management, including ... quality review, case review for third party payers' requirements. Ensures optimal reimbursement ...
Quick apply
Miami, FL · On-site
... insurance company reimbursement policies. Performs utilization review and management, including ... quality review, case review for third party payers' requirements. Ensures optimal reimbursement ...
Saint Louis, MO · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Saint Louis, MO · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Wayne, PA · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Wayne, PA · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Saint Louis, MO · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Saint Louis, MO · On-site
$52K - $76K/yr
Prior review experience in healthcare, insurance, utilization management, quality assurance, or other applicable capacity. * Prior experience in the workers' compensations field. Benefits We're ...
Washington, DC · On-site
Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...
Washington, DC · On-site
Now Hiring: RN Utilization Review - Washington, DC Are you a passionate RN professional looking for ... Medical, Vision & Dental insurance * 401(k) Matching Program * Flexible Schedules * Travel ...
Odessa, TX · On-site
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
Odessa, TX · On-site
Familiar with medical terminology, utilization review, and/or medical insurance preferred. Ability to communicate effectively and professionally, both verbally and in writing.
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
Gadsden, AL · On-site
This role works closely with insurance providers, health plans, Utilization Review teams, the Business Office, and Case Managers to help ensure timely follow-up on authorizations, reviews, appeals ...
For Insurance Utilization Review Slp jobs, the most frequently searched job titles are:

Columbus, OH • On-site
Other
Re-posted 2 days ago
Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Medicaid Division
Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications: Background Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience) Potential for longer term dependent on enrollment Workers will be doing Concurrent Inpatient Review MUST have one of the following AT LEAST -Utilization Review in hospital setting Nurses who are used to doing both production and review work
All your information will be kept confidential according to EEO guidelines.
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Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Recruiting and staffing services
51 - 200 Employees
Edison, NJ, US
1996