In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Previous utilization review experience in a psychiatric healthcare facility preferred. * License:
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
In addition to your base compensation, this position also offers: * Health (Medical, Dental, Vision ... Qualifications and requirements Bachelor's Degree Previous utilization review experience in a ...
This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 ... Maintain accurate records, compile reports, and support utilization review program operations
This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 ... Maintain accurate records, compile reports, and support utilization review program operations
This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 ... Maintain accurate records, compile reports, and support utilization review program operations
This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 ... Maintain accurate records, compile reports, and support utilization review program operations
This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 ... Maintain accurate records, compile reports, and support utilization review program operations
This is a remote position but will need onsite training in Mishawaka Indiana. Shift: PRN/Days - 8 ... Maintain accurate records, compile reports, and support utilization review program operations
This position is onsite at the facility and is not a remote position. Roles and Responsibilities: ESSENTIAL FUNCTIONS: • Assigns all clients to Utilization Review staff and supervises staff to ...
This position is onsite at the facility and is not a remote position. Roles and Responsibilities: ESSENTIAL FUNCTIONS: • Assigns all clients to Utilization Review staff and supervises staff to ...
Utilization Review RN
Indianapolis, IN · On-site
... non-clinical positions with some of the largest and most prestigious healthcare facilities ... setting reviews to ensure compliance with applicable criteria, medical policy, and member ...
Utilization Review RN
Indianapolis, IN · On-site
... non-clinical positions with some of the largest and most prestigious healthcare facilities ... setting reviews to ensure compliance with applicable criteria, medical policy, and member ...
... thorough review of the total resources available to patient pre and post-discharge from ... This position is on-site at RHI The Rehabilitation Hospital of Indiana is an equal opportunity ...
Quick apply
... thorough review of the total resources available to patient pre and post-discharge from ... This position is on-site at RHI The Rehabilitation Hospital of Indiana is an equal opportunity ...
... thorough review of the total resources available to patient pre and post-discharge from ... This position is on-site at RHI The Rehabilitation Hospital of Indiana is an equal opportunity ...
... thorough review of the total resources available to patient pre and post-discharge from ... This position is on-site at RHI The Rehabilitation Hospital of Indiana is an equal opportunity ...
Anticipated End Date: 2026-08-24 Position Title: Utilization Management Rep I Utilization ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Anticipated End Date: 2026-08-24 Position Title: Utilization Management Rep I Utilization ... Refers cases requiring clinical review to a Nurse reviewer. * Responsible for the identification ...
Utilization Management Nurse
Columbus, IN · On-site
... quality reviews within strict efficiency standards is required for this position. Key ... utilization review, and medical necessity * Act and perform within the scope of professional ...
Utilization Management Nurse
Columbus, IN · On-site
... quality reviews within strict efficiency standards is required for this position. Key ... utilization review, and medical necessity * Act and perform within the scope of professional ...
... quality reviews within strict efficiency standards is required for this position. Key ... utilization review, and medical necessity - Act and perform within the scope of professional ...
Quick apply
... quality reviews within strict efficiency standards is required for this position. Key ... utilization review, and medical necessity - Act and perform within the scope of professional ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... position/department. * Consistently utilizes appropriate universal precautions, protective ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... position/department. * Consistently utilizes appropriate universal precautions, protective ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... position/department. * Consistently utilizes appropriate universal precautions, protective ...
W/Alt UM Nurse (BHS)
Granger, IN · On-site
Critical utilization management functions during the admission phase include admission review for ... position/department. * Consistently utilizes appropriate universal precautions, protective ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management ... Performs medical review activities pertaining to utilization review, quality assurance, and medical ...
Position Purpose: Assist the Chief Medical Director to direct and coordinate the medical management ... Performs medical review activities pertaining to utilization review, quality assurance, and medical ...
UR Coordinator (PRN)
Kouts, IN · On-site
Position Summary: The UR Coordinator is responsible for managing the treatment activities offered ... reviewers to establish the length of stay or number of certified days. • Coordinate with the ...
UR Coordinator (PRN)
Kouts, IN · On-site
Position Summary: The UR Coordinator is responsible for managing the treatment activities offered ... reviewers to establish the length of stay or number of certified days. • Coordinate with the ...
Position Aetna Utilization Review information
What is the difference between Position Aetna Utilization Review vs Medical Reviewer?
| Aspect | Position Aetna Utilization Review | Medical Reviewer |
|---|---|---|
| Credentials | RN, LPN, or licensed healthcare professional | MD, DO, or licensed healthcare provider |
| Work Environment | Insurance company, primarily office-based | Hospitals, clinics, or insurance settings |
| Industry Usage | Commonly employed in health insurance companies like Aetna | Used across healthcare facilities and insurance companies |
Position Aetna Utilization Review involves assessing insurance claims and determining coverage based on medical necessity, often performed by licensed healthcare professionals. Medical Reviewers, typically physicians, evaluate medical records and provide expert opinions on patient care. While both roles require healthcare credentials, Aetna Utilization Review focuses on insurance processes, whereas Medical Reviewers focus on clinical assessments.
What are popular job titles related to Position Aetna Utilization Review jobs in Indiana? For Position Aetna Utilization Review jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Position Aetna Utilization Review jobs in Indiana look for? The top searched job categories for Position Aetna Utilization Review jobs in Indiana are:
- Aetna Utilization Review Nurse
- Flex Schedule Utilization Review
- Coordinator Aetna Utilization Review
- Director Optum Utilization Review
- Utilization Review Manager
- Freelance International Utilization Review Nurse
- Remote Supervisor Utilization Management
- Part Time Utilization Review
- Remote Insurance Utilization Review
- Remote Utilization Review
What cities in Indiana are hiring for Position Aetna Utilization Review jobs? Cities in Indiana with the most Position Aetna Utilization Review job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 4 days ago
LifePoint Health rating
6.0
Based on 271 frontline employees who took The Breakroom Quiz
748th of 887 rated healthcare providers
Job description
Your experience matters
At Sycamore Springs, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.
What we offer
Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:
- Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
- Competitive Paid Time Off
- Employee Assistance Program - mental, physical, and financial wellness assistance
- Tuition Reimbursement/Assistance for qualified applicants
- And much more...
About Us
People are our passion and purpose. Sycamore Springs is a 48 bed hospital located in Layfette, IN and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters
How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to managed care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Essential Functions:
- Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
- Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
- Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
- Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
- Works with DON to ensure documentation requirements are met.
- Ensure appeals are completed thoroughly and on a timely basis.
- Interface with managed care organizations, external reviews, and other payers.
- Communicate with physicians to schedule peer to peer reviews.
- Accurately report denials.
Qualifications and requirements
Bachelor's Degree
Previous utilization review experience in a psychiatric healthcare facility preferred.
EEOC Statement:
Sycamore Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.What LifePoint Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About LifePoint Health
Sourced by ZipRecruiter
Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Brentwood, TN, US
Year founded
1999