Remote Key Responsibilities: * Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. * Verify insurance benefits ...
Quick apply
Remote Key Responsibilities: * Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. * Verify insurance benefits ...
Quick apply
Remote Key Responsibilities: * Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. * Verify insurance benefits ...
Pompano Beach, FL ยท Remote
$45K - $65K/hr
Remote Key Responsibilities: * Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. * Verify insurance benefits ...
Pompano Beach, FL ยท Remote
$45K - $65K/hr
Remote Key Responsibilities: * Manage a caseload of 50-75 patients and authorize 15-25 cases daily, ensuring timely utilization reviews and appropriate level of care. * Verify insurance benefits ...
Boca Raton, FL ยท Remote
$73K - $96K/yr
The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team for optimal/efficient patient ...
Boca Raton, FL ยท Remote
$73K - $96K/yr
The purpose of this position is to conduct initial, concurrent, retrospective chart review for clinical financial resource utilization. Coordinates with healthcare team for optimal/efficient patient ...
Boca Raton, FL ยท On-site +1
$73K - $96K/yr
Facilitates communication between payers, review agencies, healthcare team. Identify delays in treatment or inappropriate utilization and serves as a resource. Coordinates communication with ...
Boca Raton, FL ยท On-site +1
$73K - $96K/yr
Facilitates communication between payers, review agencies, healthcare team. Identify delays in treatment or inappropriate utilization and serves as a resource. Coordinates communication with ...
Miami, FL ยท Remote
$204K - $292K/yr
At least one (1) year of utilization review experience preferred PAY RANGE: $204,761 - $292,515 ... Remote
Miami, FL ยท Remote
$204K - $292K/yr
At least one (1) year of utilization review experience preferred PAY RANGE: $204,761 - $292,515 ... Remote
Miami, FL ยท On-site +1
$204K - $292K/yr
At least one (1) year of utilization review experience preferred PAY RANGE: $204,761 - $292,515 ... Remote
Miami, FL ยท On-site +1
$204K - $292K/yr
At least one (1) year of utilization review experience preferred PAY RANGE: $204,761 - $292,515 ... Remote
Plantation, FL ยท On-site +1
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
Plantation, FL ยท On-site +1
$25.75 - $33.25/hr
Experience with utilization management systems or clinical decision-making tools such as Medical ... Effectively work independently and as a team, in a remote setting. Required and Preferred ...
West Palm Beach, FL ยท Remote
$23 - $31.50/hr
... utilization reviews, audits and more. We are looking for someone who can provide litigation support ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...
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West Palm Beach, FL ยท Remote
$23 - $31.50/hr
... utilization reviews, audits and more. We are looking for someone who can provide litigation support ... Apple equipment and a media stipend are provided for remote workspace. ABOUT DANE STREET: A fast ...
Delray Beach, FL ยท Remote
$68K - $100K/yr
Certification in Case Management or Utilization Review preferred Core expectations * Demonstrate ... US remote-based colleagues are not permitted to work from a location outside of the United States ...
Delray Beach, FL ยท Remote
$68K - $100K/yr
Certification in Case Management or Utilization Review preferred Core expectations * Demonstrate ... US remote-based colleagues are not permitted to work from a location outside of the United States ...
Certification in Case Management or Utilization Review preferred Core expectations * Demonstrate ... US remote-based colleagues are not permitted to work from a location outside of the United States ...
Certification in Case Management or Utilization Review preferred Core expectations * Demonstrate ... US remote-based colleagues are not permitted to work from a location outside of the United States ...
Cooper City, FL ยท Remote
... appeals, utilization review, or medical necessity denials. * 2+ years in a leadership or ... Experience managing remote and/or offshore teams (Philippines experience preferred). * Strong ...
Cooper City, FL ยท Remote
... appeals, utilization review, or medical necessity denials. * 2+ years in a leadership or ... Experience managing remote and/or offshore teams (Philippines experience preferred). * Strong ...
Hollywood, FL ยท Remote
$53.25 - $64/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Hollywood, FL ยท Remote
$53.25 - $64/hr
Review prior authorization requests for accuracy, appropriateness, and clinical necessity. * Apply ... Prior authorization, utilization management, or managed care preferred - retail or hospital ...
Hollywood, FL ยท On-site +1
$52.25 - $63.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Hollywood, FL ยท On-site +1
$52.25 - $63.75/hr
Review clinical documentation for medication coverage appeals and grievances. * Apply evidence ... Prior managed care or utilization management experience preferred - retail and hospital pharmacists ...
Plantation, FL ยท Remote
... utilization. * Prepare and present Monthly Reports, Quarterly Business Reviews (QBRs), and ad hoc ... Internship experience accepted. * Technical Proficiency: Proficient in Microsoft Office Suite ...
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Plantation, FL ยท Remote
... utilization. * Prepare and present Monthly Reports, Quarterly Business Reviews (QBRs), and ad hoc ... Internship experience accepted. * Technical Proficiency: Proficient in Microsoft Office Suite ...
Plantation, FL ยท Remote
$125K - $131K/yr
... utilization. * Prepare and present Monthly Reports, Quarterly Business Reviews (QBRs), and ad hoc ... Internship experience accepted. * Technical Proficiency: Proficient in Microsoft Office Suite ...
Quick apply
Plantation, FL ยท Remote
$125K - $131K/yr
... utilization. * Prepare and present Monthly Reports, Quarterly Business Reviews (QBRs), and ad hoc ... Internship experience accepted. * Technical Proficiency: Proficient in Microsoft Office Suite ...
Miami, FL ยท On-site +1
The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in ... Remote
Miami, FL ยท On-site +1
The Physician Reviewer is the primary physician reviewer for Utilization Management (UM) cases in ... Remote
Fort Lauderdale, FL ยท On-site +1
$33 - $44.50/hr
... coding and reviewing documentationguidelines * Ability to work independently in a remote ... utilization review or related clinical roles. Clinical background preferred (RN, LPN, PA,NP ...
Fort Lauderdale, FL ยท On-site +1
$33 - $44.50/hr
... coding and reviewing documentationguidelines * Ability to work independently in a remote ... utilization review or related clinical roles. Clinical background preferred (RN, LPN, PA,NP ...
$10.49 - $12.09
2% of jobs
$12.09 - $13.69
4% of jobs
$15.28 is the 25th percentile. Wages below this are outliers.
$13.69 - $15.28
19% of jobs
$15.28 - $16.88
24% of jobs
The median wage is $16.98 / hr.
$16.88 - $18.48
17% of jobs
$19.44 is the 75th percentile. Wages above this are outliers.
$18.48 - $20.07
16% of jobs
$20.07 - $21.67
6% of jobs
$21.67 - $23.27
5% of jobs
$23.27 - $24.86
3% of jobs
$24.86 - $26.46
3% of jobs
$26.46 - $28.06
1% of jobs
$10
$18
$28
| Aspect | Internship Remote Utilization Review | Utilization Review Specialist |
|---|---|---|
| Credentials | Typically pursuing or holding relevant certifications (e.g., CCM, RN) | Requires active certification and experience in utilization review |
| Work Environment | Remote, internship setting, often part-time or supervised | Full-time, remote or onsite, with more independent responsibilities |
| Industry Usage | Entry-level, training phase within healthcare and insurance sectors | Professional role with established responsibilities in healthcare management |
In summary, an Internship Remote Utilization Review is a training position for individuals gaining experience in utilization review, often with supervision and limited responsibilities. A Utilization Review Specialist is a fully qualified professional responsible for evaluating healthcare services, requiring certifications and more independence in their role.
Full-time
Posted 5 days ago
We are seeking a Utilization Review Specialist to join our corporate team in Pompano Beach, FL. The position is responsible for contacting external case managers and managed care organizations for pre-authorization and concurrent reviews for the duration of a patientโs treatment stay. They also establish and maintain contracts with managed care companies and requests rate increases when deemed appropriate.
Position Details:Manage a caseload of 50โ75 patients and authorize 15โ25 cases daily, ensuring timely utilization reviews and appropriate level of care.
Verify insurance benefits, coordinate authorizations, and communicate effectively with managed care providers.
Conduct admission and continuing-stay reviews to assess medical necessity and ensure compliance with treatment standards.
Collaborate with clinical and billing departments to support discharge planning, documentation, and timely reimbursement.
Identify and address over/underutilization trends and assist in resolving outstanding case issues with insurers.
This is more than a job, itโs a chance to be a vital part of what recovery looks like after treatment. As a Utilization Review Specialist, youโll help ensure that each client leaves treatment with a clear plan, strong connections, and the resources they need to continue their recovery journey with confidence.
If you're passionate about building bridges to lasting recovery and ensuring every patient has a plan beyond our doors, apply today and help us continue making a difference at Banyan Treatment Centers.
We are an Equal Opportunity Employer and welcome applicants of all backgrounds. We encourage veterans, active-duty military, and first responders to apply in support of our First Responders Program.Sourced by ZipRecruiter
Recruiting and staffing services
1 - 10 Employees
Milwaukee, WI, US
2014