Norfolk, VA · On-site
$60 - $80/hr
The Utilization Review Nurse is responsible for utilization management services within the scope of ... therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the ...
Norfolk, VA · On-site
$60 - $80/hr
The Utilization Review Nurse is responsible for utilization management services within the scope of ... therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
Danville, VA · On-site
$26 - $35/hr
... Assist in preparing Utilization Review Reports as necessary. • Coordinates and makes ... with families, payors, therapists and physicians both verbally and in writing. Must also ...
Danville, VA · On-site
$26 - $35/hr
... Assist in preparing Utilization Review Reports as necessary. • Coordinates and makes ... with families, payors, therapists and physicians both verbally and in writing. Must also ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
... with families, payors, therapists and physicians both verbally and in writing. Must also ... · Assist in preparing Utilization Review Reports as necessary. · Coordinates and makes ...
Prepare recommendations for prescribers to optimize therapy and reduce risk. * Document reviews and ensure compliance with state, federal, and health-plan requirements. * Contribute to quality ...
Prepare recommendations for prescribers to optimize therapy and reduce risk. * Document reviews and ensure compliance with state, federal, and health-plan requirements. * Contribute to quality ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity ... or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity ... or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity ... or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off ...
The Utilization Review Advisor (Advisor) position conducts timely and compliant medical necessity ... or therapy sessions, per person, per year, at no cost. Work/Life Balance: offering paid time off ...
Danville, VA · On-site
... review and respond to concerns expressed by customers. Together with the appropriate Department ... with families, payors, therapists and physicians both verbally and in writing. Must also ...
Danville, VA · On-site
... review and respond to concerns expressed by customers. Together with the appropriate Department ... with families, payors, therapists and physicians both verbally and in writing. Must also ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Danville, VA · On-site
$79K - $95K/yr
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Danville, VA · On-site
$79K - $95K/yr
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Three to five years of experience in utilization review and case management. RN, LCSW, LPC, LMFT, or LCP in Virginia required. EEO Statement All UHS subsidiaries are committed to providing an ...
Richmond, VA · On-site
$115K - $140K/yr
This role provides oversight for drug utilization review, medication safety programs, and pharmacy ... Collaborate with providers to promote safe and effective medication therapy management * Evaluate ...
Quick apply
Richmond, VA · On-site
$115K - $140K/yr
This role provides oversight for drug utilization review, medication safety programs, and pharmacy ... Collaborate with providers to promote safe and effective medication therapy management * Evaluate ...
Annandale, VA · On-site
$80 - $100/hr
Participate in care planning and utilization review meetings * Educate residents, families, and staff on therapy goals and plans * Maintain productivity and documentation standards * Support ...
Annandale, VA · On-site
$80 - $100/hr
Participate in care planning and utilization review meetings * Educate residents, families, and staff on therapy goals and plans * Maintain productivity and documentation standards * Support ...
$45 - $58/hr
Participate in care planning and utilization review meetings * Educate residents, families, and staff on therapy goals and plans * Maintain productivity and documentation standards * Support ...
Quick apply
$45 - $58/hr
Participate in care planning and utilization review meetings * Educate residents, families, and staff on therapy goals and plans * Maintain productivity and documentation standards * Support ...
$45 - $58/hr
Participate in care planning and utilization review meetings * Educate residents, families, and staff on therapy goals and plans * Maintain productivity and documentation standards * Support ...
Quick apply
$45 - $58/hr
Participate in care planning and utilization review meetings * Educate residents, families, and staff on therapy goals and plans * Maintain productivity and documentation standards * Support ...
$15.49 - $18.91
14% of jobs
$21.74 is the 25th percentile. Wages below this are outliers.
$18.91 - $22.34
14% of jobs
$22.34 - $25.76
17% of jobs
The median wage is $27.64 / hr.
$25.76 - $29.18
11% of jobs
$29.18 - $32.61
8% of jobs
$32.61 - $36.03
6% of jobs
$38.60 is the 75th percentile. Wages above this are outliers.
$36.03 - $39.45
7% of jobs
$39.45 - $42.88
7% of jobs
$42.88 - $46.30
5% of jobs
$46.30 - $49.72
5% of jobs
$49.72 - $53.15
5% of jobs
$15
$31
$53
| Aspect | Therapy Utilization Review | Speech-Language Pathologist |
|---|---|---|
| Credentials | Typically requires healthcare or insurance-related certifications | Requires a master's degree in speech-language pathology and state licensure |
| Work Environment | Insurance companies, healthcare organizations, or utilization review departments | Hospitals, clinics, schools, or private practice |
| Industry Usage | Focuses on evaluating therapy necessity and coverage | Provides direct therapy services to patients with speech or language disorders |
While Therapy Utilization Review involves assessing the necessity of therapy services for insurance coverage, Speech-Language Pathologists provide direct patient care. Both roles require healthcare knowledge, but they differ in focus: one is review-based, the other is clinical service delivery.
For Therapy Utilization Review jobs in Virginia, the most frequently searched job titles are:
The top searched job categories for Therapy Utilization Review jobs in Virginia are:
$60 - $80/hr
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 6 days ago
Conduct utilization management services including prior authorization, retrospective review, and medical director referrals.
Review provider requests for services requiring authorization and conduct pre-certification and care coordination to ensure treatment appropriateness.
Provide written and/or verbal notification to members and providers regarding approval or denial decisions.
City/State Norfolk, VA Work Shift First (Days) Overview: Sentara Health Plans Community Care is looking to hire a Utilization Review Nurse. The Utilization Review Nurse is responsible for utilization management services within the scope of licensure. Conducts primary functions of prior authorization, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider requests for services requiring authorization. Conducts pre-certification, care coordination for appropriateness of treatment, set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts. Responsible for written and/or verbal notification to members and providers. Ensures medical director written decision is consistent with criteria (CMS, state, medical policy, clinical criteria). Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.
EducationTalroo- Health, Utilization Review Nurse, RN, Care Coordination, or Discharge Planning, Case Management, Milliman, NCQA
BenefitsCaring For Your Family and Your Career
Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
In support of our mission “to improve health every day,” this is a tobacco-free environment. For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Sentara Health is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering hundreds of sites of care including 12 hospitals, PACE, home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan.
The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
