Washington, DC · On-site
Medical
Dental
Vision
Retirement
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
Medical
Dental
Vision
Retirement
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
$33.60 - $50.40/hr
Medical
Dental
Vision
Life
Retirement
PTO
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Washington, DC · On-site
$33.60 - $50.40/hr
Medical
Dental
Vision
Life
Retirement
PTO
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Washington, DC · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Washington, DC · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Washington, DC · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Washington, DC · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Life Insurance and Disability Insurances * Flexible Spending Account * Pre-tax Metro SmartTrip ... Six months psychiatric utilization review either for hospital or external review organization ...
Clinton, MD · On-site
$89K - $162K/yr
Utilization Review Supervisor Candidate must have acute care Utilization Review experience ... Identifies insurance information obtains authorization communicates with financial counseling and ...
Clinton, MD · On-site
$89K - $162K/yr
Utilization Review Supervisor Candidate must have acute care Utilization Review experience ... Identifies insurance information obtains authorization communicates with financial counseling and ...
Hanover, MD · On-site
Medical
Dental
Vision
Retirement
PTO
Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off ... experience in Managed Care/Utilization Review is required Many organizations talk about ...
Hanover, MD · On-site
Medical
Dental
Vision
Retirement
PTO
Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off ... experience in Managed Care/Utilization Review is required Many organizations talk about ...
Hanover, MD · On-site
Medical
Dental
Vision
Retirement
PTO
Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off ... experience in Managed Care/Utilization Review is required Many organizations talk about ...
Hanover, MD · On-site
Medical
Dental
Vision
Retirement
PTO
Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off ... experience in Managed Care/Utilization Review is required Many organizations talk about ...
Clinton, MD · On-site
$89K - $162K/yr
About the Job Candidate must have acute care Utilization Review experience. Candidate must live in ... Identifies insurance information obtains authorization communicates with financial counseling and ...
Clinton, MD · On-site
$89K - $162K/yr
About the Job Candidate must have acute care Utilization Review experience. Candidate must live in ... Identifies insurance information obtains authorization communicates with financial counseling and ...
Hanover, MD · On-site
Medical
Dental
Vision
Retirement
PTO
Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off ... experience in Managed Care/Utilization Review is required Many organizations talk about ...
Hanover, MD · On-site
Medical
Dental
Vision
Retirement
PTO
Medical, Dental, and Vision Insurance. * 403B Savings Plan w/employer contribution. * Paid Time off ... experience in Managed Care/Utilization Review is required Many organizations talk about ...
Clinton, MD · On-site
$89K - $162K/yr
About the Job **Must be local to the DC/MD region with acute Utilization Review RN experience ... Management insurance UR or related experience preferred Licenses and Certifications * RN - ...
Clinton, MD · On-site
$89K - $162K/yr
About the Job **Must be local to the DC/MD region with acute Utilization Review RN experience ... Management insurance UR or related experience preferred Licenses and Certifications * RN - ...
Washington, DC · On-site
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site +1
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site +1
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site +1
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site +1
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Washington, DC · On-site
Medical
Retirement
PTO
... review. It is within the BH UM Reviewer's discretion to retain requests for additional information ... events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: * Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: * Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Assists in utilization reviews and insurance appeals. Responds to inquiries from patients, their families, and professional referral sources. Roles and Responsibilities: • Assists the admissions ...
Silver Spring, MD · On-site
$2.9K/wk
Medical
Dental
Vision
Life
Retirement
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week ... life insurance beginning day one of your assignment, generous 401(k) match, substantial housing ...
Silver Spring, MD · On-site
$2.9K/wk
Medical
Dental
Vision
Life
Retirement
Utilization Review * Discipline: RN * Start Date: ASAP * Duration: 13 weeks * 40 hours per week ... life insurance beginning day one of your assignment, generous 401(k) match, substantial housing ...
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34--$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Annapolis, MD · On-site
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34-$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
Annapolis, MD · On-site
$34 - $55/hr
Medical
Dental
Vision
Life
Retirement
PTO
Reviews the medical record by applying utilization review criteria, to assess clinical, financial ... Pay Range $34-$55 USD Luminis Health Benefits Overview: • Medical, Dental, and Vision Insurance ...
$24.23 - $29.13
2% of jobs
$29.13 - $34.03
9% of jobs
$37.39 is the 25th percentile. Wages below this are outliers.
$34.03 - $38.93
21% of jobs
The median wage is $42.90 / hr.
$38.93 - $43.83
23% of jobs
$43.83 - $48.73
13% of jobs
$52.55 is the 75th percentile. Wages above this are outliers.
$48.73 - $53.63
10% of jobs
$53.63 - $58.54
8% of jobs
$58.54 - $63.44
5% of jobs
$63.44 - $68.34
5% of jobs
$68.34 - $73.24
2% of jobs
$73.24 - $78.14
2% of jobs
$24
$47
$78
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.
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.
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.
For Insurance Utilization Review jobs in Washington, the most frequently searched job titles are:
The top searched job categories for Insurance Utilization Review jobs in Washington are:
Cities in Washington with the most Insurance Utilization Review job openings:
Other
Medical, Dental, Vision, Retirement
Posted 13 days ago
Are you a passionate RN professional looking for a new adventure? Prime Time Healthcare is seeking dynamic individuals like you to join our team in Washington, DC and make a real impact in patient care!
In this role, you'll be at the forefront of healthcare, delivering top-notch care with precision and compassion. As an integral part of our team, you'll collaborate closely with fellow healthcare professionals, ensuring every patient receives the highest level of care possible.
If you're ready to elevate your career and make a difference in the lives of others, apply today!
At Prime Time Healthcare, we offer competitive compensation along with a large range of benefits including:
Prime Time Healthcare, LLC is an Equal Opportunity Employer (EOE).
*Estimated pay and benefits packages are on a per facility basis and may change with market conditions. Exact pay and benefits package will be negotiated with Prime Time Healthcare and may vary with several factors including but not limited to, guaranteed hours, travel distance, demand, eligibility, etc.
Sourced by ZipRecruiter
PrimeTime Healthcare, based in Omaha, NE, US, is a leading provider of staffing solutions in the healthcare industry. According to information accessed from their official website, primetimehealthcare.com, the company specializes in placing high-quality healthcare professionals into temporary and travel positions across a vast network of healthcare facilities nationwide. Founded in 2012, PrimeTime Healthcare quickly established a reputation for customer-focused and result-oriented services, earning it a place on Staffing Industry Analyst’s fastest-growing staffing companies list.
Recruiting and staffing services
51 - 200 Employees
Omaha, NE, US
2012
