The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for ... Health, dental, prescription, and vision coverage for full-time & part-time employees * Short-term ...
The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for ... Health, dental, prescription, and vision coverage for full-time & part-time employees * Short-term ...
JOIN OUR TEAM AS A Administrative Assistant - Utilization Review - Part Time Your Work Matters How will you make a difference? The Administrative Assistant is responsible for providing administrative ...
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JOIN OUR TEAM AS A Administrative Assistant - Utilization Review - Part Time Your Work Matters How will you make a difference? The Administrative Assistant is responsible for providing administrative ...
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Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Care Management Status: Part time Benefits Eligible: Yes Hou rs Per Week: 20 Schedule Details ... Knowledge of Utilization Review criteria; * Strong critical thinking skills for applying medical ...
Care Management Status: Part time Benefits Eligible: Yes Hou rs Per Week: 20 Schedule Details ... Knowledge of Utilization Review criteria; * Strong critical thinking skills for applying medical ...
This role will be a part-time position. The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and ...
This role will be a part-time position. The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity reviews and assists with denials management (facilitating and ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
PURPOSE STATEMENT: Proactively monitor utilization of services for patients to optimize ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Proactively monitor utilization of services for patients to optimize reimbursement for the facility ... Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ...
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Employment Type: PART_TIME
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Employment Type: PART_TIME
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
FTE: Part-Time (.6 FTE) ⏰ Schedule: Wednesday - Thursday - 7:00 PM - 7:00 AM Plays a critical ... Minimum of three (3) years of experience in utilization review, utilization management, or case ...
FTE: Part-Time (.6 FTE) ⏰ Schedule: Wednesday - Thursday - 7:00 PM - 7:00 AM Plays a critical ... Minimum of three (3) years of experience in utilization review, utilization management, or case ...
Gainesville, FL FTE: Part-Time (.6 FTE) ⏰ Schedule: Wednesday - Thursday - 7:00 PM - 7:00 AM ... Minimum of three (3) years of experience in utilization review, utilization management, or case ...
Gainesville, FL FTE: Part-Time (.6 FTE) ⏰ Schedule: Wednesday - Thursday - 7:00 PM - 7:00 AM ... Minimum of three (3) years of experience in utilization review, utilization management, or case ...
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Incentives Utilization Management | Miamisburg | Part-time | Varied Shift Overview Kettering Health ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Utilization Specialist LPN
Lafayette, LA · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Employment Type: PART_TIME
Utilization Specialist LPN
Lafayette, LA · On-site
Conduct reviews, in accordance with certification requirements, of insurance plans or other managed ... Employment Type: PART_TIME
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Job Details Utilization Management | Miamisburg | Part-time | Varied Shift Responsibilities ... Role focuses on review of inpatient and observation admissions to ensure correct assignment of ...
New
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
New
Utilization Management | Miamisburg | Part-time | Varied Shift * Registered professional nurse with education, knowledge and experience. * Role focuses on review of inpatient and observation ...
New
... timely review of healthcare service and coverage denials. In this position, you will evaluate ... You will collaborate closely with Medical Directors, Utilization Management, and Case Management ...
... timely review of healthcare service and coverage denials. In this position, you will evaluate ... You will collaborate closely with Medical Directors, Utilization Management, and Case Management ...
... timely review of healthcare service and coverage denials. In this position, you will evaluate ... You will collaborate closely with Medical Directors, Utilization Management, and Case Management ...
... timely review of healthcare service and coverage denials. In this position, you will evaluate ... You will collaborate closely with Medical Directors, Utilization Management, and Case Management ...
Utilization Mgmt Rep- Per Diem (As Needed)
Oak Brook, IL · On-site
$20.80 - $31.20/hr
Department: 11215 Advocate Aurora Health Corporate - Utilization Management Status: Part time ... Communicate clinical needs, authorizations, and denials to the Utilization Review Nurses and ...
Utilization Mgmt Rep- Per Diem (As Needed)
Oak Brook, IL · On-site
$20.80 - $31.20/hr
Department: 11215 Advocate Aurora Health Corporate - Utilization Management Status: Part time ... Communicate clinical needs, authorizations, and denials to the Utilization Review Nurses and ...
HSA with qualifying HDHP plans with company match * 401k plan with company match (Part-time ... A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and ...
Quick apply
HSA with qualifying HDHP plans with company match * 401k plan with company match (Part-time ... A Case Manager/Utilization Review Nurse, in collaboration with patients/families, physicians and ...
Part Time Utilization Review information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do part time utilization review jobs pay per hour?
How to make an extra 2000 a month as a nurse?
How to get a utilization review job?
What is a Part Time Utilization Review job?
What are some common challenges faced in a part-time utilization review role and how can I effectively manage them?
Is utilization review a stressful job?
What is the difference between Part Time Utilization Review vs Part Time Case Management?
| Aspect | Part Time Utilization Review | Part Time Case Management |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications (e.g., RN, LPN, or medical reviewer credentials) | Often requires social work, nursing, or healthcare certifications, with some overlap |
| Work Environment | Healthcare facilities, insurance companies, or third-party review organizations | Hospitals, insurance companies, or community health agencies |
| Employer & Industry Usage | Used mainly in insurance and healthcare to evaluate medical necessity | Used in healthcare to coordinate patient care and services |
Part Time Utilization Review focuses on assessing the medical necessity of services, while Part Time Case Management involves coordinating patient care and services. Both roles require healthcare credentials and are common in insurance and healthcare settings, but they serve different functions within patient care and resource management.
What are the key skills and qualifications needed to thrive as a Part Time Utilization Review Nurse, and why are they important?
What jobs pay 4000 a week without a degree?
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Part-time
Medical, Dental, Vision, Life, Retirement
Re-posted 27 days ago
Job description
Come work at the best place to give and receive care!
Job Description:
This Role is On-Site
Who We Are:
Southern NH Medical Centers strives to keep patients on a continuous track to discharge and receive the continuity of care that our patients and their families need. Our Patient and Family Services Department is the driving force to assure communication, respect, and safety follows our patients throughout the admission phase, all the way through the discharge process. This department includes a dedicated team of Case Managers, Social Workers, and Interpreters that ensure that all care is equal, and our patient's dignity is maintained above all else.
About the Job:
The Utilization Review/Denial Specialist works with the care team to evaluate medical acuity for the appropriate level of care orders and documentation to facilitate insurance coverage, and proactively prevent denials. This specialist ensures level of care charges are applied accurately and meet compliance with CMS and commercial insurance guidelines as well as reviewing appeal options for medical necessity insurance denials
What You'll Do:
- Assess acute medical necessity utilizing appropriate criteria.
- Collect and trend Utilization Review data metrics.
- Review appeal options for commercial insurance, RAC, and QIO medical necessity denials.
- Understand and apply CMSRegulations to meet compliance
Who You Are:
- Current NH Nursing License as a Registered Nurse.
- ASN accepted; BSN required within 10 years of hire.
- A minimum of 5-years' of experience as a Registered Nurse.
- Experience in use of Interqual, Milliman or other Healthcare acute criteria preferred.
Why You'll Love Us:
- Health, dental, prescription, and vision coverage for full-time & part-time employees
- Short-term, long-term disability, life & pet insurance
- Student Loan Forgiveness & Discounts
- 403(b) Retirement savings plans
- Continuous earned time accrual
& So much more!
Work Shift:
Per diem weekends and holiday. Other days available if staff have availability.SolutionHealth is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, disability status, veteran status, or any other characteristic protected by law.
About SolutionHealth
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Nashua, NH, US
Year founded
2018