Utilization Review Specialist
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Company Paid Life Insurance and Disability and more! We are an Equal Opportunity Employer!
Tulsa, OK · On-site
$17.44/hr
Job Posting Title Utilization Review Specialist I Agency 452 MENTAL HEALTH AND SUBSTANCE ABUSE SERV ... A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
Tulsa, OK · On-site
$17.44/hr
Job Posting Title Utilization Review Specialist I Agency 452 MENTAL HEALTH AND SUBSTANCE ABUSE SERV ... A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
Tulsa, OK · On-site
Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E ... A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
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Tulsa, OK · On-site
Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E ... A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
Tulsa, OK · On-site
$17.44/hr
Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E ... A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
Tulsa, OK · On-site
$17.44/hr
Utilization Review Specialist I Join a team that CARES! Here at ODMHSAS, we believe in I.C.A.R.E ... A wide choice of health insurance plans with no pre-existing condition exclusions or limitations
The utilization review and management (UM) component program ensures that external healthcare ... Familiarity with healthcare regulations, insurance policies, and quality improvement processes is ...
Quick apply
The utilization review and management (UM) component program ensures that external healthcare ... Familiarity with healthcare regulations, insurance policies, and quality improvement processes is ...
$30.10 - $49.17/hr
Utilization Review, Utilization Management, Advocacy and Education * Responsible for review of ... life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship ...
$30.10 - $49.17/hr
Utilization Review, Utilization Management, Advocacy and Education * Responsible for review of ... life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship ...
Oklahoma City, OK · On-site
Serves as liaison for patients and facility with insurance companies. Negotiates and advocates for patient length of stay and level of care. Coordinates utilization review activities with other ...
Oklahoma City, OK · On-site
Serves as liaison for patients and facility with insurance companies. Negotiates and advocates for patient length of stay and level of care. Coordinates utilization review activities with other ...
Analyzing patient cases for insurance utilization review. Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: Performs other duties as assigned.
Analyzing patient cases for insurance utilization review. Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: Performs other duties as assigned.
Analyzing patient cases for insurance utilization review. Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: Performs other duties as assigned.
Analyzing patient cases for insurance utilization review. Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: Performs other duties as assigned.
... for insurance utilization review. · Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: · Performs other duties as assigned. Minimum ...
... for insurance utilization review. · Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: · Performs other duties as assigned. Minimum ...
Analyzing patient cases for insurance utilization review. * Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: * Performs other duties as ...
Analyzing patient cases for insurance utilization review. * Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: * Performs other duties as ...
Analyzing patient cases for insurance utilization review. * Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: * Performs other duties as ...
Analyzing patient cases for insurance utilization review. * Ensuring adequate follow up metal health services are arranged for the patient. General Responsibilities: * Performs other duties as ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
... Review * Previous experience in a supervisory role * CPHQ, CPUR and previous insurance experience ... Knowledge of quality improvement and utilization management WORK ENVIRONMENT: Current work ...
Broken Arrow, OK · On-site
$19 - $25/hr
Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ... Experience in case management, utilization review, or discharge planning a plus.
Broken Arrow, OK · On-site
$19 - $25/hr
Knowledge of Medicare benefits and insurance processes and contracts. * Knowledge of accreditation ... Experience in case management, utilization review, or discharge planning a plus.
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
Quick apply
... peer review services, trusted by insurance carriers and organizations across the country for ... and utilization review/management expertise * Expanded credentials as an expert in Independent ...
$19.75 - $23.75
2% of jobs
$23.75 - $27.74
9% of jobs
$30.48 is the 25th percentile. Wages below this are outliers.
$27.74 - $31.74
21% of jobs
The median wage is $34.97 / hr.
$31.74 - $35.73
23% of jobs
$35.73 - $39.73
13% of jobs
$42.84 is the 75th percentile. Wages above this are outliers.
$39.73 - $43.73
10% of jobs
$43.73 - $47.72
8% of jobs
$47.72 - $51.72
5% of jobs
$51.72 - $55.71
5% of jobs
$55.71 - $59.71
2% of jobs
$59.71 - $63.70
2% of jobs
$19
$39
$63
One common challenge in Insurance Utilization Review is balancing the need for cost-effective care with the clinical needs of patients, which often requires careful analysis and decision-making. Professionals in this role frequently navigate complex medical records, strict policy guidelines, and collaborate with healthcare providers who may advocate strongly for particular treatments. Managing challenging conversations while maintaining professionalism and ensuring timely determinations are also a regular part of the role. Developing expertise in these areas can make the job both demanding and rewarding, while building a strong foundation for career growth within healthcare administration.
To thrive in Insurance Utilization Review, you generally need a strong background in healthcare or nursing, an understanding of medical terminology, and analytical thinking skills, often supported by an RN license or relevant clinical experience. Familiarity with utilization management software, coding systems like ICD-10, and knowledge of regulatory requirements (such as Medicare or Medicaid) are important. Strong communication, attention to detail, and problem-solving abilities help professionals excel when interacting with providers and insurers. These skills are essential to ensure appropriate care is authorized while maintaining regulatory compliance and cost-effectiveness.
An Insurance Utilization Review job involves evaluating medical treatments and services to determine if they are necessary, appropriate, and covered by a patient's insurance plan. Professionals in this role review medical records, treatment plans, and insurance policies to ensure compliance with guidelines and cost-effectiveness. They work closely with healthcare providers, insurance companies, and patients to facilitate approvals or appeals. The goal is to balance quality patient care with cost containment in the healthcare system.

Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 21 days ago
Sourced by ZipRecruiter
Offices of mental health practitioners
201 - 500 Employees
Tulsa, OK, US
1959