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 ...
Utilization Review Nurse
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 ...
Utilization Review Nurse
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 ...
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 ...
Utilization Review Nurse
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 ...
Utilization Review Nurse
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 ...
Registered Nurse, Utilization Review
Syracuse, NY · On-site
$72K - $83K/yr
The Utilization Review Nurse assists the utilization review process taking on various tasks ... Receives and responds to Office of Temporary and Disability Assistance (OTDA) notifications of Fair ...
Registered Nurse, Utilization Review
Syracuse, NY · On-site
$72K - $83K/yr
The Utilization Review Nurse assists the utilization review process taking on various tasks ... Receives and responds to Office of Temporary and Disability Assistance (OTDA) notifications of Fair ...
Prime Staffing is seeking a travel nurse RN Utilization Review for a travel nursing job in ... We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire ...
Prime Staffing is seeking a travel nurse RN Utilization Review for a travel nursing job in ... We offer a wide range of staffing services including temporary, temp-to-perm, and direct hire ...
Utilization Review * Discipline: RN * Start Date: 09/05/2026 * Duration: 13 weeks * 40 hours per ... Aetna • Supplemental dental, vision, and life insurance • Combination of taxable and non ...
Utilization Review * Discipline: RN * Start Date: 09/05/2026 * Duration: 13 weeks * 40 hours per ... Aetna • Supplemental dental, vision, and life insurance • Combination of taxable and non ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Utilization Review RN
$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 ...
Utilization Review RN
$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 ...
Utilization Review RN
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 ...
Utilization Review RN
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 ...
Emory Healthcare Clinical Utilization Review Nurse Preceptor Be inspired. Be rewarded. Belong. At ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
Emory Healthcare Clinical Utilization Review Nurse Preceptor Be inspired. Be rewarded. Belong. At ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ... Utilization Review Job Type Regular Full-Time Job Number 169232 Job Category Nursing Schedule 8a-4 ...
Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ... Utilization Review Job Type Regular Full-Time Job Number 169232 Job Category Nursing Schedule 8a-4 ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
The UR Coordinator attends treatment team meetings and continued stay reviews as indicated ... TEMPORARY
The UR Coordinator attends treatment team meetings and continued stay reviews as indicated ... TEMPORARY
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be ... Must have a valid, active unencumbered Nursing license or temporary permit approved by the Georgia ...
Temporary Aetna 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 temporary aetna utilization review jobs pay per hour?
What is the difference between Temporary Aetna Utilization Review vs Temporary Health Insurance Claims Processor?
| 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.
Full-time
Re-posted 15 days ago
Job description
The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at Britelife Recovery. This role ensures timely approvals and continued stay authorizations from insurance payers by effectively communicating clinical information and advocating for appropriate levels of care.
The UR Specialist works closely with clinical staff, admissions, medical providers, and third-party payers to support patient access to treatment and maintain financial viability for the organization. Success in this role requires strong clinical judgment, documentation skills, familiarity with ASAM criteria, and a working knowledge of insurance guidelines specific to behavioral health
What tasks are required?
- Conduct initial and concurrent reviews for detox, residential, partial hospitalization (PHP), and intensive outpatient (IOP) levels of care.
- Obtain prior authorizations and continued stay approvals from commercial and other payers by submitting timely clinical reviews and documentation.
- Communicate clinical necessity of services based on ASAM criteria and DSM-5 diagnoses.
- Track and document all insurance-related communications, decisions, and outcomes in the EHR and UR logs.
- Collaborate with clinicians, therapists, case managers, and medical staff to gather accurate and up-to-date clinical information for reviews.
- Ensure treatment plans, progress notes, and assessments are completed on time and accurately reflect medical necessity.
- Participate in multidisciplinary team meetings to stay informed on client progress and treatment goals.
- Assist staff with proper documentation practices to support insurance justification and compliance.
- Maintain compliance with payer policies, HIPAA regulations, and internal utilization management protocols.
- Monitor trends in denials, approvals, and length-of-stay metrics to support organizational performance improvement.
- Assist in appeals and peer reviews by gathering required documentation and preparing clinical summaries.
- Provide training and support to staff on documentation best practices related to utilization review.
- Special projects as assigned
What we need from you?
- Minimum of 2-3 years of experience in utilization review, case management, or insurance coordination in a behavioral health or substance use treatment setting.
- Knowledge of ASAM criteria and levels of care for substance use and co-occurring disorders.
- Familiarity with managed care principles, insurance authorizations, and payer requirements.
- Bachelor's degree in Nursing, Social Work, Psychology, or a related field required; advanced degree or licensure (e.g., RN, LCSW, LPC, LMHC, or CADC) preferred.
- Excellent organizational, communication, and time management skills.
- Proficiency in Electronic Health Records (EHRs), insurance portals, and Microsoft Office tools.
- Bachelor's degree in Nursing, Social Work, Psychology, or a related field required; advanced degree or licensure (e.g., RN, LCSW, LPC, LMHC, or CADC) preferred.
- Experience or working knowledge with Collaborative MD and KIPU
- Experience in detox and residential SUD programs.
- Knowledge of major insurance provider platforms (e.g., Optum, Aetna, BCBS, Cigna).
- Strong clinical writing skills and familiarity with medical necessity language.
- Ability to advocate for clients while balancing payer relationships and compliance.
- Ability to lift up to 25 pounds.
- Ability to walk up and down stairs during emergency drills or situations.
All ARS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. ARS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.
About BriteLife Recovery
Sourced by ZipRecruiter
Industry
Fitness and sports centers
Company size
51 - 200 Employees
Headquarters location
Englewood Cliffs, NJ, US
Year founded
2015