Pittsfield, MA · On-site
$1.8K - $2.5K/wk
Short-term disability, life insurance, paid jury duty * Access to the largest network of facilities and providers in the country * Industry experienced workforce management team * Licensure and ...
Pittsfield, MA · On-site
$1.8K - $2.5K/wk
Short-term disability, life insurance, paid jury duty * Access to the largest network of facilities and providers in the country * Industry experienced workforce management team * Licensure and ...
Albany, NY · On-site
$60/hr
Health insurance (subject to plan eligibility). * Full-time, 5 days per week. * The opportunity to ... utilization review in an acute or ambulatory care facility (preferred). * Knowledge of current ...
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Albany, NY · On-site
$60/hr
Health insurance (subject to plan eligibility). * Full-time, 5 days per week. * The opportunity to ... utilization review in an acute or ambulatory care facility (preferred). * Knowledge of current ...
Albany, NY · On-site
$60/hr
Health insurance, subject to plan eligibility requirements. * Full-time, 5 days per week ... or utilization review, preferred. * Knowledge of current disease/care management/coordination ...
Quick apply
Albany, NY · On-site
$60/hr
Health insurance, subject to plan eligibility requirements. * Full-time, 5 days per week ... or utilization review, preferred. * Knowledge of current disease/care management/coordination ...
Albany, NY · On-site
$60/hr
Health insurance (subject to plan eligibility). * Full-time, 5 days per week. * The opportunity to ... utilization review in an acute or ambulatory care facility (preferred). * Knowledge of current ...
Quick apply
Albany, NY · On-site
$60/hr
Health insurance (subject to plan eligibility). * Full-time, 5 days per week. * The opportunity to ... utilization review in an acute or ambulatory care facility (preferred). * Knowledge of current ...
Albany, NY · On-site
$50/hr
... Health Insurance ~ PTO & Paid Sick Time ~ 401(k) with 3% matching (after 1 year) ~ License ... or utilization review preferred ~ Knowledge of current disease|care management and coordination ...
Albany, NY · On-site
$50/hr
... Health Insurance ~ PTO & Paid Sick Time ~ 401(k) with 3% matching (after 1 year) ~ License ... or utilization review preferred ~ Knowledge of current disease|care management and coordination ...
Albany, NY · On-site
$50/hr
... Health Insurance ~ PTO & Paid Sick Time ~ 401(k) with 3% matching (after 1 year) ~ License ... or utilization review preferred ~ Knowledge of current disease|care management and coordination ...
Albany, NY · On-site
$50/hr
... Health Insurance ~ PTO & Paid Sick Time ~ 401(k) with 3% matching (after 1 year) ~ License ... or utilization review preferred ~ Knowledge of current disease|care management and coordination ...
Guilderland, NY · On-site
$60/hr
Health Insurance subject to plan eligibility requirements * Work Schedule: Full-time position, 5 ... utilization review, preferred. * Knowledgeable of current disease/care management/coordination ...
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Guilderland, NY · On-site
$60/hr
Health Insurance subject to plan eligibility requirements * Work Schedule: Full-time position, 5 ... utilization review, preferred. * Knowledgeable of current disease/care management/coordination ...
Saratoga Springs, NY · On-site
$33.60 - $56.50/hr
... utilization review/management, readmission avoidance action plan strategies, care transitions ... Monitors daily insurance logs for accuracy and appropriate patient status. Appropriately identifies ...
Saratoga Springs, NY · On-site
$33.60 - $56.50/hr
... utilization review/management, readmission avoidance action plan strategies, care transitions ... Monitors daily insurance logs for accuracy and appropriate patient status. Appropriately identifies ...
Saratoga Springs, NY · On-site
$38 - $60/hr
... utilization review/management, readmission avoidance action plan strategies, care transitions ... Monitors daily insurance logs for accuracy and appropriate patient status. Appropriately identifies ...
Saratoga Springs, NY · On-site
$38 - $60/hr
... utilization review/management, readmission avoidance action plan strategies, care transitions ... Monitors daily insurance logs for accuracy and appropriate patient status. Appropriately identifies ...
Glenville, NY · On-site
$25 - $41.13/hr
Performs utilization review, provides progress reports and develop aftercare plans in conjunction with referring persons/agencies, EAPs and managed care/insurance entities. * Participates in quality ...
Glenville, NY · On-site
$25 - $41.13/hr
Performs utilization review, provides progress reports and develop aftercare plans in conjunction with referring persons/agencies, EAPs and managed care/insurance entities. * Participates in quality ...
Glenville, NY · On-site
$25 - $41.13/hr
Performs utilization review, provides progress reports and develop aftercare plans in conjunction with referring persons/agencies, EAPs and managed care/insurance entities. * Participates in quality ...
Glenville, NY · On-site
$25 - $41.13/hr
Performs utilization review, provides progress reports and develop aftercare plans in conjunction with referring persons/agencies, EAPs and managed care/insurance entities. * Participates in quality ...
Glenville, NY · On-site
$25 - $41.13/hr
Performs utilization review, provides progress reports and develop aftercare plans in conjunction with referring persons/agencies, EAPs and managed care/insurance entities. * Participates in quality ...
Quick apply
Glenville, NY · On-site
$25 - $41.13/hr
Performs utilization review, provides progress reports and develop aftercare plans in conjunction with referring persons/agencies, EAPs and managed care/insurance entities. * Participates in quality ...
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... Acquisition and maintenance of Insurance License(s) may be required to comply with state ...
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... Acquisition and maintenance of Insurance License(s) may be required to comply with state ...
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... Acquisition and maintenance of Insurance License(s) may be required to comply with state ...
Perform Utilization Review activities prospectively, concurrently or retrospectively in accordance ... Acquisition and maintenance of Insurance License(s) may be required to comply with state ...
Schenectady, NY · On-site
Previous case management, utilization review, and discharge planning experience is highly preferred ... insurance companies as needed to effectively execute discharge planning services, such as but not ...
Schenectady, NY · On-site
Previous case management, utilization review, and discharge planning experience is highly preferred ... insurance companies as needed to effectively execute discharge planning services, such as but not ...
$19.25 - $25/hr
Previous case management, utilization review, and discharge planning experience is highly preferred ... insurance companies as needed to effectively execute discharge planning services, such as but not ...
$19.25 - $25/hr
Previous case management, utilization review, and discharge planning experience is highly preferred ... insurance companies as needed to effectively execute discharge planning services, such as but not ...
Pittsfield, MA · On-site
$21.92/hr
... EMR optimization, utilization review and provider relationships. In addition, the Practice ... Experience with BH Insurance and the appeals process preferred. * Computer/data entry experience ...
Pittsfield, MA · On-site
$21.92/hr
... EMR optimization, utilization review and provider relationships. In addition, the Practice ... Experience with BH Insurance and the appeals process preferred. * Computer/data entry experience ...
Pittsfield, MA · On-site
$21.92/hr
... EMR optimization, utilization review and provider relationships. In addition, the Practice ... Experience with BH Insurance and the appeals process preferred. * Computer/data entry experience ...
Pittsfield, MA · On-site
$21.92/hr
... EMR optimization, utilization review and provider relationships. In addition, the Practice ... Experience with BH Insurance and the appeals process preferred. * Computer/data entry experience ...
Albany, NY · On-site
$130 - $140/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Albany, NY · On-site
$130 - $140/hr
... Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance ... insurance benefits) to qualifying employees. All compensation determinations are based on the ...
Latham, NY · On-site
$114K - $136K/yr
Our client, a Health Insurance company, is looking for a Clinical Pharmacist 1 for their Latham, NY ... Drug Utilization Review: * As a member of the DUR team , conducts evaluations, and prepares reports ...
Latham, NY · On-site
$114K - $136K/yr
Our client, a Health Insurance company, is looking for a Clinical Pharmacist 1 for their Latham, NY ... Drug Utilization Review: * As a member of the DUR team , conducts evaluations, and prepares reports ...
$21.04 - $25.29
2% of jobs
$25.29 - $29.55
9% of jobs
$32.46 is the 25th percentile. Wages below this are outliers.
$29.55 - $33.80
21% of jobs
The median wage is $37.25 / hr.
$33.80 - $38.06
23% of jobs
$38.06 - $42.31
13% of jobs
$45.62 is the 75th percentile. Wages above this are outliers.
$42.31 - $46.57
10% of jobs
$46.57 - $50.83
8% of jobs
$50.83 - $55.08
5% of jobs
$55.08 - $59.34
5% of jobs
$59.34 - $63.59
2% of jobs
$63.59 - $67.85
2% of jobs
$21
$41
$67
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 Troy, NY, the most frequently searched job titles are:
Cities near Troy, NY with the most Insurance Utilization Review job openings:
$1.8K - $2.5K/wk
Contractor
Medical, Dental, Vision, Life, Retirement
This job post has expired 4 days ago. Applications are no longer accepted.
AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Management for a travel nursing job in Pittsfield, Massachusetts.
Job Description & RequirementsJob Description & Requirements
RN - Case Manager
StartDate: 9/21/2026 Pay Rate: $1800.00 - $2500.00
POSITION SUMMARY: RN Case Manager
POSITION DUTIES: DCP
MINIMUM REQUIRED QUALIFICATIONS: 3+ years of experience, RN, MA License
LENGTH OF ASSIGNMENT: 13 weeks
SHIFT / HOURS PER WEEK: M-F, 7am-3:30pm
START DATE: 9/21
Facility Location
Pittsfield is the cultural and commercial hub of the Berkshires, the beautiful highland region esteemed for its scenic splendor and rich culture. The Berkshires are known for the spectacular outdoors and entertainment options that they offer and Pittsfield is certainly no exception. Downtown features a wealth of shops, galleries and theaters. Be sure to take in a play at the famous Colonial Theater. Pittsfield State Forest offers some of the most beautiful views that The Berkshires have to offer, as well as a bevy of recreational and sporting options.
Job Benefits
Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:
AMN Healthcare Revenue Cycle Job ID #3567091. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: RN - Case Manager
About AMN Healthcare Revenue CycleAMN Healthcare is a leading force in the healthcare industry, committed to being the most trusted, innovative, and influential partner for healthcare organizations. With a focus on providing quality patient care, AMN Healthcare offers holistic solutions that reduce costs, streamline processes, and improve efficiencies. The company boasts over 30 years of experience and takes pride in staffing leading healthcare facilities with the nation's best travelers. As an industry leader, AMN Healthcare offers a diverse team dedicated to supporting healthcare workers and facilities, ensuring a personalized and supportive experience for both clients and candidates.
