Houston, TX · On-site
$38 - $42/hr
... to the Manager and/or Medical Director. * Monday to Friday 8-5 six positions available Thurs- Sun 10 hr days six positions available Required Qualifications for RN Outpatient Utilization Review ...
Houston, TX · On-site
$38 - $42/hr
... to the Manager and/or Medical Director. * Monday to Friday 8-5 six positions available Thurs- Sun 10 hr days six positions available Required Qualifications for RN Outpatient Utilization Review ...
Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...
Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...
Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...
Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...
Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...
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Utilization Management Representative (UMR) Work Location: 11511 Shadow Creek Parkway Schedule: Monday - Friday | 8:00 AM - 5:00 PM | 24-40 hours per week Interview Process: Virtual interview via ...
Utilization Management Representative The Utilization Management Representative (UMR) plays a vital role in supporting the Utilization Management department by ensuring the timely and accurate ...
Utilization Management Representative The Utilization Management Representative (UMR) plays a vital role in supporting the Utilization Management department by ensuring the timely and accurate ...
Responsible for the coordination and management of a full-service Utilization Management program to service the TDCJ, TJJD and other contracted inmate populations. Scope : Contribute to the success ...
New
Responsible for the coordination and management of a full-service Utilization Management program to service the TDCJ, TJJD and other contracted inmate populations. Scope : Contribute to the success ...
New
Responsible for the coordination and management of a full-service Utilization Management program to service the TDCJ, TJJD and other contracted inmate populations. Scope : Contribute to the success ...
New
Responsible for the coordination and management of a full-service Utilization Management program to service the TDCJ, TJJD and other contracted inmate populations. Scope : Contribute to the success ...
New
Responsible for the coordination and management of a full-service Utilization Management program to service the TDCJ, TJJD and other contracted inmate populations. Scope : Contribute to the success ...
New
Responsible for the coordination and management of a full-service Utilization Management program to service the TDCJ, TJJD and other contracted inmate populations. Scope : Contribute to the success ...
New
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
We are searching for a Utilization Management Assistant- Someone who receives, processes and completes data entry of demographic information on all referral/authorization requests from participating ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Minimum one year experience in a Utilization Management department in behavioral health or as a Mental Health Tech * Maintains education and development appropriate for position. * May substitute ...
Pearland, TX · Remote
$16 - $29/hr
The Utilization Management Representative (UMR) provides office support for all units within the Utilization Management and/or Population Health Department. (Utilization Review, Concurrent Review ...
Pearland, TX · Remote
$16 - $29/hr
The Utilization Management Representative (UMR) provides office support for all units within the Utilization Management and/or Population Health Department. (Utilization Review, Concurrent Review ...
Manage insurance authorizations, denials, appeals, and level-of-care determinations. * Monitor utilization trends and contribute to quality improvement initiatives that enhance patient outcomes and ...
New
Manage insurance authorizations, denials, appeals, and level-of-care determinations. * Monitor utilization trends and contribute to quality improvement initiatives that enhance patient outcomes and ...
New
This role seamlessly integrates care coordination, clinical assessment, and utilization management to support strong recovery outcomes, uphold regulatory and payer requirements, and strengthen ...
This role seamlessly integrates care coordination, clinical assessment, and utilization management to support strong recovery outcomes, uphold regulatory and payer requirements, and strengthen ...
This role seamlessly integrates care coordination, clinical assessment, and utilization management to support strong recovery outcomes, uphold regulatory and payer requirements, and strengthen ...
This role seamlessly integrates care coordination, clinical assessment, and utilization management to support strong recovery outcomes, uphold regulatory and payer requirements, and strengthen ...
Manage insurance authorizations, denials, appeals, and level-of-care determinations. * Monitor utilization trends and contribute to quality improvement initiatives that enhance patient outcomes and ...
Quick apply
Manage insurance authorizations, denials, appeals, and level-of-care determinations. * Monitor utilization trends and contribute to quality improvement initiatives that enhance patient outcomes and ...
Houston, TX · On-site
$67K - $85K/yr
We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of ... Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned ...
Houston, TX · On-site
$67K - $85K/yr
We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of ... Behavioral Health Utilization Manager will perform concurrent and discharge reviews on assigned ...
Houston, TX · On-site
... management. This role demands a solid clinical nursing background, sharp analytical skills, and a ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
Houston, TX · On-site
... management. This role demands a solid clinical nursing background, sharp analytical skills, and a ... utilization review activities accurately and timely within the electronic health record (EHR). o ...
$37.2K - $48K
15% of jobs
$48K - $58.8K
8% of jobs
$60.3K is the 25th percentile. Wages below this are outliers.
$58.8K - $69.5K
15% of jobs
The median wage is $76.3K / yr.
$69.5K - $80.3K
20% of jobs
$80.3K - $91.1K
11% of jobs
$96.5K is the 75th percentile. Wages above this are outliers.
$91.1K - $101.8K
13% of jobs
$101.8K - $112.6K
5% of jobs
$112.6K - $123.4K
3% of jobs
$123.4K - $134.1K
4% of jobs
$134.1K - $144.9K
3% of jobs
$144.9K - $155.7K
3% of jobs
$37.2K
$85.5K
$155.7K
To thrive in Utilization Management, you need a strong understanding of healthcare procedures, insurance guidelines, and case review processes, usually backed by a clinical background such as RN, LPN, or allied health certification. Familiarity with medical management software, electronic health records (EHR), and utilization review tools like InterQual or MCG is often required. Excellent analytical thinking, attention to detail, and effective communication skills greatly enhance performance in this role. These competencies enable accurate assessment of medical necessity, ensure regulatory compliance, and support efficient, collaborative workflows between providers, insurers, and patients.
A Utilization Management (UM) job involves evaluating medical services to ensure they are necessary, cost-effective, and compliant with healthcare guidelines. Professionals in this field review patient care plans, authorize treatments, and collaborate with healthcare providers to optimize resource use. They work for insurance companies, hospitals, or healthcare organizations to balance quality care with cost control. Strong analytical skills and knowledge of medical policies are essential in this role.
As a Utilization Management professional, your day-to-day duties typically include reviewing patient admissions, authorizing ongoing treatment or procedures, assessing medical necessity, and ensuring services comply with insurance policies and industry guidelines. You will frequently collaborate with physicians, nurses, and insurance representatives to facilitate timely and appropriate care decisions while managing cost and quality. Documentation and communication play key roles as you help bridge the gap between clinical teams and payers. This role is often fast-paced, requires decisive action, and provides opportunities to have a direct impact on patient outcomes and organizational efficiency.
$38 - $42/hr
Other
Medical, Dental, Life
Posted 6 days ago
Sourced by ZipRecruiter
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Recruiting and staffing services
201 - 500 Employees
Maitland, FL, US
2003
