Augusta, GA · On-site
The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that ...
Augusta, GA · On-site
The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that ...
Omaha, NE · On-site
... a Utilization Review Specialist in Omaha to join its Medical Management team. The individual ... Triages and manages intake coordination of requests for authorization and independent medical ...
Omaha, NE · On-site
... a Utilization Review Specialist in Omaha to join its Medical Management team. The individual ... Triages and manages intake coordination of requests for authorization and independent medical ...
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Is the liaison between third party payors and actively participates in denial management activities.
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Is the liaison between third party payors and actively participates in denial management activities.
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Is the liaison between third party payors and actively participates in denial management activities.
New
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Is the liaison between third party payors and actively participates in denial management activities.
New
Utilization Review Coordinator Location: Everwell Port St. Lucie Hospital, Inc Position Summary ... Adept in identifying potential problems within the department and seeks management guidance.
Quick apply
Utilization Review Coordinator Location: Everwell Port St. Lucie Hospital, Inc Position Summary ... Adept in identifying potential problems within the department and seeks management guidance.
Pompano Beach, FL · On-site
$50K - $65K/yr
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...
Pompano Beach, FL · On-site
$50K - $65K/yr
Utilization Review Specialist | Remote | Full-Time $50,000 - $65,000 Annually | Weekdays (Weekend ... In this remote role, you'll manage a caseload of 50-75 patients, conducting admission and ...
Omaha, NE · On-site
... a Utilization Review Specialist in Omaha to join its Medical Management team. The individual ... Triages and manages intake coordination of requests for authorization and independent medical ...
Omaha, NE · On-site
... a Utilization Review Specialist in Omaha to join its Medical Management team. The individual ... Triages and manages intake coordination of requests for authorization and independent medical ...
Canton, MA · On-site
$55 - $60/hr
The ideal candidate will have a strong background in managed care, utilization management, medical necessity review, prior authorization, and outpatient clinical review. This role is responsible for ...
Canton, MA · On-site
$55 - $60/hr
The ideal candidate will have a strong background in managed care, utilization management, medical necessity review, prior authorization, and outpatient clinical review. This role is responsible for ...
Augusta, GA · On-site
Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued ...
Augusta, GA · On-site
Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued ...
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Is the liaison between third party payors and actively participates in denial management activities.
West Chester, PA · On-site
Summary: * The Utilization Review Nurse will provide utilization review for authorization ... Is the liaison between third party payors and actively participates in denial management activities.
Carteret, NJ · On-site
Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review ...
Carteret, NJ · On-site
Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site. The Utilization Review ...
Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued ...
Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued ...
At least 2 years utilization management experience in acute admission and concurrent reviews * Intermediate level experience with InterQual and/or MCG criteria within the last two years * Proficiency ...
At least 2 years utilization management experience in acute admission and concurrent reviews * Intermediate level experience with InterQual and/or MCG criteria within the last two years * Proficiency ...
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced ... Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up ...
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced ... Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up ...
Tempe, AZ · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
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Tempe, AZ · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Quick apply
Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Act as a resource person for the case management department regarding payer rules, regulations ... Utilization Review Coordinator $56971.20-$84749.60 INCENTIVE: Not Applicable EQUAL OPPORTUNITY ...
Act as a resource person for the case management department regarding payer rules, regulations ... Utilization Review Coordinator $56971.20-$84749.60 INCENTIVE: Not Applicable EQUAL OPPORTUNITY ...
Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime This position includes a $1,500 sign on bonus! For over 60 years, Calvary Healing Center has provided a full ...
Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime This position includes a $1,500 sign on bonus! For over 60 years, Calvary Healing Center has provided a full ...
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Tulsa, OK · On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
Quick apply
Miami, FL · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Previous experience conducting concurrent or inpatient reviews for a managed care plan This is an ...
$39K - $50.7K
9% of jobs
$59.3K is the 25th percentile. Wages below this are outliers.
$50.7K - $62.4K
22% of jobs
$62.4K - $74K
11% of jobs
The median wage is $81.2K / yr.
$74K - $85.7K
14% of jobs
$85.7K - $97.4K
12% of jobs
$104.7K is the 75th percentile. Wages above this are outliers.
$97.4K - $109.1K
13% of jobs
$109.1K - $120.8K
13% of jobs
$120.8K - $132.5K
5% of jobs
$132.5K - $144.1K
2% of jobs
$144.1K - $155.8K
0% of jobs
$155.8K - $167.5K
0% of jobs
$39K
$91K
$167.5K
Cities with the most Manager Anthem Utilization Review job openings:
The most popular types of Anthem Utilization Review jobs are:
States with the most job openings for Manager Anthem Utilization Review jobs include:
Other
Medical, Dental, Vision, Retirement, PTO
Posted 12 days ago
Lighthouse Care Center of Augusta has been providing psychiatric services to the CSRA for more than 15 years. Located in Augusta, GA, our 84-bed facility provides a therapeutic setting for those seeking treatment for mental illness. Lighthouse Care Center offers unique and individualized programming for adolescents and adults that sets us apart from many other treatment facilities, and our tenured team includes seasoned medical staff.
The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care; ensuring that delivery of high-quality and cost-effective treatment is consistent with the mission, vision, and values of Universal Health Services and in accordance with government regulation, licensing, and accreditation requirements. Under the direction of the UR Manager, the Utilization Review Coordinator is responsible for conducting clinical review of data to determine eligibility respective to pre-certification and continued stay reviews.
Job duties/responsibilities include reviewing clinical content of medical records, participating in treatment team meetings, and collaborating with physicians, therapists, nurses, and pertinent staff on gathering the necessary data to communicate with insurance companies/authorizing entities to ensure initial precertification and continued authorization is achieved. Ensure input of pre-certifications and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment team on any follow-ups necessary, verify insurance coverage at the first of the month, and post patient payments into MS4. Trained in all aspects relative to timely gathering of clinical criteria, communication of clinical criteria, and entry of supporting clinical criteria into computer-based systems, in addition to other job duties.
Benefit highlights include a referral bonus program, challenging and rewarding work environment, competitive compensation & generous paid time off, excellent medical, dental, vision, and prescription drug plans, 401(k) with company match and discounted stock plan, and career development opportunities within UHS and its 300+ subsidiaries!
