The Utilization Management Specialist is responsible for establishing a professional and supportive ... Experience using electronic medical record applications (Central Reach preferred). * Working ...
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The Utilization Management Specialist is responsible for establishing a professional and supportive ... Experience using electronic medical record applications (Central Reach preferred). * Working ...
Quick apply
The Utilization Management Specialist is responsible for establishing a professional and supportive ... Experience using electronic medical record applications (Central Reach preferred). * Working ...
The role requires interfacing with the case managers, medical team, other hospital staff, physician ... Performs timely and accurate utilization review for all patient populations, using nationally ...
New
The role requires interfacing with the case managers, medical team, other hospital staff, physician ... Performs timely and accurate utilization review for all patient populations, using nationally ...
New
Under general supervision by management, and in collaboration with Medical Directors and other ... utilization information; assists with program processes for transitions across levels of care ...
Under general supervision by management, and in collaboration with Medical Directors and other ... utilization information; assists with program processes for transitions across levels of care ...
Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria ...
Details: Under minimal supervision, provides medical and/or behavioral health utilization management for members of Medical Plan in accordance with the schedule of benefits and network criteria ...
Baltimore, MD · Remote
$19 - $24/hr
... Management. * Bachelor's Degree in Nursing. Responsibilities ... Determines medical necessity and appropriateness by referencing regulatory mandates, contracts ...
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Baltimore, MD · Remote
$19 - $24/hr
... Management. * Bachelor's Degree in Nursing. Responsibilities ... Determines medical necessity and appropriateness by referencing regulatory mandates, contracts ...
Skokie, IL · On-site +1
... medical necessity and compliance of utilization review guidelines. * Obtain initial and continuing authorization for treatment services. * Manage authorization denials including referral for peer ...
Skokie, IL · On-site +1
... medical necessity and compliance of utilization review guidelines. * Obtain initial and continuing authorization for treatment services. * Manage authorization denials including referral for peer ...
... medical necessity and compliance of utilization review guidelines. * Obtain initial and continuing authorization for treatment services. * Manage authorization denials including referral for peer ...
Quick apply
... medical necessity and compliance of utilization review guidelines. * Obtain initial and continuing authorization for treatment services. * Manage authorization denials including referral for peer ...
Position Purpose With minimal supervision the Inpatient Utilization Management Specialist assesses ... Experience conducting medical reviews within medical, behavioral health and/or long-term care ...
Position Purpose With minimal supervision the Inpatient Utilization Management Specialist assesses ... Experience conducting medical reviews within medical, behavioral health and/or long-term care ...
Utilization Management Specialist Make an impact by supporting the right care at the right time ... Evaluates patient medical records to determine the medical necessity and appropriateness of health ...
Utilization Management Specialist Make an impact by supporting the right care at the right time ... Evaluates patient medical records to determine the medical necessity and appropriateness of health ...
Utilization Management Specialist Make an impact by supporting the right care at the right time ... Evaluates patient medical records to determine the medical necessity and appropriateness of health ...
Utilization Management Specialist Make an impact by supporting the right care at the right time ... Evaluates patient medical records to determine the medical necessity and appropriateness of health ...
Baltimore, MD · Remote
$68/hr
Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation ... Analyze clinical information, contracts, mandates, medical policies, evidence-based research, and ...
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Baltimore, MD · Remote
$68/hr
Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation ... Analyze clinical information, contracts, mandates, medical policies, evidence-based research, and ...
Baltimore, MD · On-site
$51.77/hr
Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation ... Analyze clinical information, contracts, mandates, medical policies, evidence-based research, and ...
Baltimore, MD · On-site
$51.77/hr
Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation ... Analyze clinical information, contracts, mandates, medical policies, evidence-based research, and ...
The UM specialist takes a primary role in ensuring the effective management of allocated resources. Qualifications To perform this job successfully, an individual must be able to perform each ...
The UM specialist takes a primary role in ensuring the effective management of allocated resources. Qualifications To perform this job successfully, an individual must be able to perform each ...
Baltimore, MD · Remote
$68/hr
Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation ... Analyze clinical information, contracts, mandates, medical policies, evidence-based research, and ...
Quick apply
Baltimore, MD · Remote
$68/hr
Utilization Management Specialist (RN) Location: Baltimore, MD Type: Contract To Hire Compensation ... Analyze clinical information, contracts, mandates, medical policies, evidence-based research, and ...
This role is responsible for ensuring medical records are handed appropriately and distributed ... Coordinates authorization for review in Medical Management System. * Regular correspondence with ...
New
This role is responsible for ensuring medical records are handed appropriately and distributed ... Coordinates authorization for review in Medical Management System. * Regular correspondence with ...
New
Utilization Management Specialist Proactively monitor utilization of services for patients to ... Monitor patient length of stay and extensions and inform clinical and medical staff on issues that ...
Utilization Management Specialist Proactively monitor utilization of services for patients to ... Monitor patient length of stay and extensions and inform clinical and medical staff on issues that ...
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Develop, implement, and maintain utilization management programs to facilitate the use of ...
Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories ... Develop, implement, and maintain utilization management programs to facilitate the use of ...
A Manager within Clinical Services is responsible for overseeing day to day operation of the clinical staff for Medical Utilization Management for all lines of business. They are responsible for ...
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A Manager within Clinical Services is responsible for overseeing day to day operation of the clinical staff for Medical Utilization Management for all lines of business. They are responsible for ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
$15.63 - $19.08
14% of jobs
$21.93 is the 25th percentile. Wages below this are outliers.
$19.08 - $22.53
14% of jobs
$22.53 - $25.98
17% of jobs
The median wage is $27.88 / hr.
$25.98 - $29.44
11% of jobs
$29.44 - $32.89
8% of jobs
$32.89 - $36.34
6% of jobs
$38.93 is the 75th percentile. Wages above this are outliers.
$36.34 - $39.79
7% of jobs
$39.79 - $43.25
7% of jobs
$43.25 - $46.70
5% of jobs
$46.70 - $50.15
5% of jobs
$50.15 - $53.61
5% of jobs
$15
$31
$53
For Medical Utilization Management Specialist jobs, the most frequently searched job titles are:

Charlotte, NC
Full-time
Re-posted 16 days ago
5.2
Based on 5 frontline employees who took The Breakroom Quiz
Conducting authorizations, benefits and clinic support for new intake and current clients.
Excellent organization and problem-solving skills
Experience using electronic medical record applications (Central Reach preferred).
Working knowledge of HIPAA regulations
Excellent interpersonal skills, good oral and written communication skills
Good organization and time management skills
Must have good working knowledge of Microsoft Office or Gmail office tools (Word, Excel, PowerPoint)
Verify client information and benefits
Email Intake packets for new clients and monitor receipt
Enter accurate demographic, benefit, and authorization information for clients into operating system
Request Financial Agreements from Client Accounts
Monitor availability of clinic space and providers
Coordinate process flow with clinics and providers
Maintain accurate documentation of service requests, testing, referrals and authorizations
Oversee receipt of authorizations and creation of accurate authorizations in operating system
Actively participate in Intake meetings and collaborate with providers and clinics for best Intake practices
Complete authorization renewals
Verify client eligibility weekly
Other duties as assigned by the intake manager
Bachelor’s Degree preferred
Must be self motivated, driven, bring energy and good communication skills
Must convey a sense of passion about helping children with autism through ABA therapy
Time management and organization
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.
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Individual, family and community social assistance
201 - 500 Employees
Charlotte, NC, US
2018