Brookfield, WI · On-site +1
Utilization Review Specialist - Behavioral Health Facility We are seeking a confident, detail-oriented Utilization Review Specialist to join our behavioral health team. This role involves reviewing ...
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Brookfield, WI · On-site +1
Utilization Review Specialist - Behavioral Health Facility We are seeking a confident, detail-oriented Utilization Review Specialist to join our behavioral health team. This role involves reviewing ...
Fort Lauderdale, FL · Remote
$80K - $100K/yr
Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard business hours Patient Volume: N/A Job Requirements: * Active RN license with Multi-State/Compact license required
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Fort Lauderdale, FL · Remote
$80K - $100K/yr
Fully Remote - Utilization Review Schedule: Full-Time, Monday-Friday Hours: Standard business hours Patient Volume: N/A Job Requirements: * Active RN license with Multi-State/Compact license required
Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...
Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...
Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
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Tempe, AZ · Remote
$35 - $45.94/hr
You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;
Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
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Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
Plano, TX · Remote
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...
Plano, TX · Remote
***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...
(CHR) Community Health Resources, Inc. is seeking a Utilization Review Therapist to manage authorization activities pertaining to IOP and Residential programs. This full-time, remote role requires a ...
(CHR) Community Health Resources, Inc. is seeking a Utilization Review Therapist to manage authorization activities pertaining to IOP and Residential programs. This full-time, remote role requires a ...
Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
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Remote, but only considering candidates in PST. FLSA Status: Exempt Travel Requirement: None ... Utilization Review on Behalf of the Clinics: * Prescreen referrals to project/anticipate ...
The Manager, Utilization Review is responsible for overseeing the daily operations of the ... HBiz complies with all applicable employment laws for remote and multi-state hiring and provides ...
The Manager, Utilization Review is responsible for overseeing the daily operations of the ... HBiz complies with all applicable employment laws for remote and multi-state hiring and provides ...
We are currently seeking Board-Certified physicians in Psychiatry to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
We are currently seeking Board-Certified physicians in Psychiatry to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
We are currently seeking Board-Certified physicians in Oncology to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
We are currently seeking Board-Certified physicians in Oncology to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...
New Lenox, IL · On-site +1
$34.73 - $45.15/hr
BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...
Boston, MA · Remote
$41.36 - $100/hr
Competent in Utilization Review, appeals, the peer-to-peer process, and Case Management. * Use ... Additional Job Details (if applicable) Remote Type Remote Work Location 1153 Centre Street ...
Boston, MA · Remote
$41.36 - $100/hr
Competent in Utilization Review, appeals, the peer-to-peer process, and Case Management. * Use ... Additional Job Details (if applicable) Remote Type Remote Work Location 1153 Centre Street ...
We are currently seeking Board-Certified physicians in DERMATOLOGY to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
We are currently seeking Board-Certified physicians in DERMATOLOGY to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with no ...
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Newark, NJ · Remote
$38 - $40/hr
Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short ... Serves as mentor/trainer to new RN's and other staff as needed, completes audits, reviews and ...
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Be Seen First
Newark, NJ · Remote
$38 - $40/hr
Position is 100% remote but will have to go to Newark, NJ to pick up equipment and short ... Serves as mentor/trainer to new RN's and other staff as needed, completes audits, reviews and ...
Roseburg, OR · Remote
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
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Roseburg, OR · Remote
$85K - $105K/yr
UTILIZATION REVIEW NURSE REMOTE Ability to travel on-site to 3031 NE STEPHENS ST., ROSEBURG OR, 97457, as needed for business operations. EMPLOYMENT TYPE: Full-Time, Exempt About Umpqua Health At ...
We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with ...
We are currently seeking Board-Certified physicians in Rheumatology to conduct independent Utilization Reviews . This is a flexible, fully remote opportunity requiring just 1-2 hours per week -with ...
Jamaica Plain, MA · On-site +1
$41.36 - $100/hr
Competent in Utilization Review, appeals, the peer-to-peer process, and Case Management. * Use ... Additional Job Details (if applicable) Remote Type Remote Work Location 1153 Centre Street ...
Jamaica Plain, MA · On-site +1
$41.36 - $100/hr
Competent in Utilization Review, appeals, the peer-to-peer process, and Case Management. * Use ... Additional Job Details (if applicable) Remote Type Remote Work Location 1153 Centre Street ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
We are currently seeking Board-Certified physicians in RADIOLOGY to conduct independent Utilization Reviews . This is a flexible remote opportunity requiring just 1-2 hours per week -with no minimum ...
$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
| Aspect | Remote Hca Utilization Review | Remote Hca Case Manager |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications, such as RN or licensed healthcare professional | Often requires RN, social work, or case management certifications |
| Work Environment | Primarily reviewing medical necessity and insurance coverage remotely | Managing patient cases, coordinating care, and discharge planning remotely |
| Employer & Industry Usage | Used by health insurance companies, healthcare providers, and utilization review organizations | Employed by hospitals, insurance companies, and healthcare organizations |
Remote Hca Utilization Review focuses on assessing medical necessity and insurance coverage, while Remote Hca Case Managers handle patient care coordination and discharge planning. Both roles require healthcare credentials and are integral to healthcare management, but they differ in daily responsibilities and focus areas.
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 19 days ago
Utilization Review Specialist – Behavioral Health Facility
We are seeking a confident, detail-oriented Utilization Review Specialist to join our behavioral health team. This role involves reviewing clinical documentation, ensuring medical necessity, managing insurance authorizations, and collaborating with providers to support appropriate and timely care for our clients.
Responsibilities:
Conduct utilization reviews and obtain prior authorizations from insurance companies
Monitor continued stay and discharge criteria for clients
Communicate effectively with clinical and administrative teams
Maintain accurate and up-to-date documentation
Ensure all documentation meets insurance and regulatory compliance standards and is completed accurately and on time.
Qualifications:
Background or experience in social work, counseling, or behavioral health is preferred
Experience in utilization review or case management for behavioral health is preferred
Strong communication and organization skills
Ability to work efficiently in a fast-paced environment
Confident, proactive, and dedicated work ethic
Benefits: Competitive salary Opportunities for professional development and career advancement Supportive and collaborative work environment Fulfilling work helping individuals with mental health or substance abuse issues
Benefits:
401(k)
Dental insurance
Flexible schedule
Health insurance
Life insurance
Paid time off
Vision insurance
