Chicago, IL · On-site
Staff may be required to contact the providers of record, vendors, or internal Aetna departments to ... MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION ...
Chicago, IL · On-site
Staff may be required to contact the providers of record, vendors, or internal Aetna departments to ... MUST HAVE UM experience, inpatient utilization management review. * MUST HAVE 1 YEAR OF UTILIZATION ...
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced ... Knowledge of major insurance provider platforms (e.g., Optum, Aetna, BCBS, Cigna). * Strong ...
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced ... Knowledge of major insurance provider platforms (e.g., Optum, Aetna, BCBS, Cigna). * Strong ...
What you will be doing? The Utilization Review (UR) Specialist is a critical member of the ... Knowledge of major insurance provider platforms (e.g., Optum, Aetna, BCBS, Cigna). * Strong ...
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What you will be doing? The Utilization Review (UR) Specialist is a critical member of the ... Knowledge of major insurance provider platforms (e.g., Optum, Aetna, BCBS, Cigna). * Strong ...
Providence, RI · On-site
... Aetna departments to obtain additional information. · Evaluates documentation/information to ... utilization management review. · MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge ...
Providence, RI · On-site
... Aetna departments to obtain additional information. · Evaluates documentation/information to ... utilization management review. · MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge ...
Reporting to the Director of Utilization Review with a dotted-line relationship to the Director of ... Optum, Aetna, Cigna, Anthem/Elevance, Colorado Access, state Medicaid programs, and Medicaid ...
New
Reporting to the Director of Utilization Review with a dotted-line relationship to the Director of ... Optum, Aetna, Cigna, Anthem/Elevance, Colorado Access, state Medicaid programs, and Medicaid ...
New
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review Registered Nurse (RN) * Shift: Day * 13 Week Contracts and more available ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review Registered Nurse (RN) * Shift: Day * 13 Week Contracts and more available ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Utilization Review * Discipline: RN * Start Date: 09/14/2026 * Duration: 8 weeks * 40 hours per ... We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire ...
New
Utilization Review * Discipline: RN * Start Date: 09/14/2026 * Duration: 8 weeks * 40 hours per ... We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire ...
New
Utilization Review * Discipline: RN * Start Date: 09/14/2026 * Duration: 13 weeks * 42.5 hours per ... We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire ...
Utilization Review * Discipline: RN * Start Date: 09/14/2026 * Duration: 13 weeks * 42.5 hours per ... We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire ...
$30 - $40/hr
RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for Appeals is ... If eligible, the benefits available for this temporary role may include the following: • Medical ...
$30 - $40/hr
RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for Appeals is ... If eligible, the benefits available for this temporary role may include the following: • Medical ...
Houston, TX · On-site
$30 - $40/hr
Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for ... If eligible, the benefits available for this temporary role may include the following: • Medical ...
Houston, TX · On-site
$30 - $40/hr
Job Title: RN Clinical Review Nurse (Utilization Review Nurse) The Clinical Review Clinician for ... If eligible, the benefits available for this temporary role may include the following: • Medical ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/28/2026 * Duration: 13 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
East Elmhurst, NY · On-site
$60 - $62/hr
Skills: * 1 year of non-acute utilization review experience - required * RN experience - preferred ... ATD is a full service provider with offerings in Contract, Permanent and Temp-to-Perm staffing ...
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East Elmhurst, NY · On-site
$60 - $62/hr
Skills: * 1 year of non-acute utilization review experience - required * RN experience - preferred ... ATD is a full service provider with offerings in Contract, Permanent and Temp-to-Perm staffing ...
Aurora, CO · On-site
Apply for Job Job ID 107171 Location Aurora Position Type Regular Regular/Temporary Regular Add to Favorite Jobs Email this Job Job Overview The Utilization Review RN participates as a member of a ...
Aurora, CO · On-site
Apply for Job Job ID 107171 Location Aurora Position Type Regular Regular/Temporary Regular Add to Favorite Jobs Email this Job Job Overview The Utilization Review RN participates as a member of a ...
Ontario, CA · On-site
$71K - $104K/yr
At least 3 years of experience in utilization review, referrals, authorizations, denials and ... Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A ...
Ontario, CA · On-site
$71K - $104K/yr
At least 3 years of experience in utilization review, referrals, authorizations, denials and ... Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A ...
$71K - $104K/yr
At least 3 years of experience in utilization review, referrals, authorizations, denials and ... Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A ...
$71K - $104K/yr
At least 3 years of experience in utilization review, referrals, authorizations, denials and ... Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/08/2026 * Duration: 12 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Fort Myers, FL · On-site
$2.1K/wk
Utilization Review * Discipline: RN * Start Date: 09/08/2026 * Duration: 12 weeks * 36 hours per ... and temporary-to-hire basis. Our mission is to provide you with a rewarding job that is well ...
Ontario, CA · On-site
$71K - $104K/yr
At least 3 years of experience in utilization review, referrals, authorizations, denials and ... Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A ...
Ontario, CA · On-site
$71K - $104K/yr
At least 3 years of experience in utilization review, referrals, authorizations, denials and ... Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary. A ...
Nevada Mass, NV · Remote
$42/hr
RN Utilization Review Behavioral Health Work Location: Telecommute (Remote) Work Hours: 8:00 AM-5 ... We specialize within the medical and healthcare industries offering temporary and permanent ...
Quick apply
Nevada Mass, NV · Remote
$42/hr
RN Utilization Review Behavioral Health Work Location: Telecommute (Remote) Work Hours: 8:00 AM-5 ... We specialize within the medical and healthcare industries offering temporary and permanent ...
$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 | Temporary Aetna Utilization Review | Temporary Health Insurance Claims Processor |
|---|---|---|
| Credentials | Typically requires healthcare-related certifications (e.g., RN, LPN, or medical background) | Requires knowledge of insurance policies and claims processing, often with insurance or administrative certifications |
| Work Environment | Healthcare settings, insurance companies, or remote | Insurance companies, claims departments, or remote |
| Employer & Industry Usage | Health insurance providers, healthcare organizations | Insurance carriers, third-party administrators |
| Search & Comparison Intent | Understanding utilization review roles within health insurance | Comparing claims processing roles in insurance industry |
Temporary Aetna Utilization Review involves assessing the necessity and appropriateness of healthcare services, often requiring medical credentials. In contrast, Temporary Health Insurance Claims Processors handle claims submissions and reimbursements, focusing on administrative tasks. Both roles are essential in health insurance but differ in responsibilities, credentials, and work environment.
Cities with the most Temporary Aetna Utilization Review job openings:
The most popular types of Aetna Utilization Review jobs are:
States with the most job openings for Temporary Aetna Utilization Review jobs include:
Chicago, IL • On-site
Other
Re-posted 6 days ago
Chicago, IL
Contract
Job Description:
Participates in the development and ongoing implementation of QM Work Plan activities.
Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives
Responsibilities:
Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.
Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.
Data gathering requires navigation through multiple system applications.
Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information.
Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.
Responsible for the review and evaluation of clinical information and documentation.
Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
Works Potential Quality of Care cases across all lines of business (Commercial and Medicare).
Independently coordinates the clinical resolution with internal/external clinician support as required.
Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data
Prepares and completes QM documents based on interpretation and application of business requirements
Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements
Assists in the development and implementation of QM projects and activities
Accountable for completing and implementation of QM Work Plan Activities
Experience:
3+ years of experience as an RN
Registered Nurse in state of residence
Must have prior authorization utilization experience
Experience with Medcompass
Skills:
MUST HAVE MEDCOMPASS or ASSURECARE exp.
MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
MUST HAVE UM experience, inpatient utilization management review.
MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG.
MUST HAVE 6 months of Prior Authorization.
Education:
Questionnaire:
Do you have experience with Medcompass?
Do you have experience with Prior Authorization?
Do you have experience with Utilization Review?
Do you have an Active Registered Nurse License?
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
It services
1,001 - 5,000 Employees
Jersey City, NJ, US
2000
