Previous utilization review experience in a psychiatric healthcare facility preferred. * License: Current unencumbered clinical license strongly preferred. * Additional Requirements: CPR ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License: Current unencumbered clinical license strongly preferred. * Additional Requirements: CPR ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License: Current unencumbered clinical license strongly preferred. * Additional Requirements: CPR ...
Previous utilization review experience in a psychiatric healthcare facility preferred. * License: Current unencumbered clinical license strongly preferred. * Additional Requirements: CPR ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
... a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management * Retrospective Review * Payer Communication & Authorization * Denials Management and Appeals Equal ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
Utilization Review and Medical Necessity * Concurrent Review and Length of Stay Management * Retrospective Review * Payer Communication & Authorization * Denials Management and Appeals Equal ...
... a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... a PRN Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
... Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay Management 3. Retrospective Review 4. Payer Communication & Authorization 5. Denials Management and Appeals Equal ...
UTILIZATION REVIEW RN
Seymour, IN · On-site
... Utilization Review and Medical Necessity 2. Concurrent Review and Length of Stay Management 3. Retrospective Review 4. Payer Communication & Authorization 5. Denials Management and Appeals Equal ...
Responsibilities The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements ...
Responsibilities The Utilization Management Manager oversees utilization management including, but not limited to: utilization review, case documentation, payer relationships, regulatory requirements ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
From your first day to your next career milestone-your experience matters How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued ...
Utilization Review RN
$30 - $34/hr
Expected to review 20 cases a day with a 95% accuracy rate. Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to ...
Utilization Review RN
$30 - $34/hr
Expected to review 20 cases a day with a 95% accuracy rate. Responsible for collaborating with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to ...
Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member ...
Conducts pre-certification, inpatient, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
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... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... review of the total resources available to patient pre and post-discharge from rehabilitation care. The Utilization Reviewer collaborates with the payer and rehabilitation team to ensure a successful ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
... for a Utilization Review Coordinator to coordinate patients' services across the continuum of care by promoting effective utilization, monitoring health resources and elaborating with ...
Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day NeuroPsychiatric Hospitals of Indianapolis is looking for a Utilization Review ...
New
Join us and be part of a team dedicated to making a lasting difference in the lives of patients and families every day NeuroPsychiatric Hospitals of Indianapolis is looking for a Utilization Review ...
New
Utilization Review 1099 information
What is a utilization review 1099?
A Utilization Review 1099 position refers to a healthcare professional, often a nurse or therapist, who works as an independent contractor (not a direct employee) to review medical cases for necessity and efficiency. The '1099' designation means they receive a Form 1099 for tax purposes and are responsible for their own taxes. Utilization Review specialists evaluate patient records to ensure treatments are appropriate and meet insurance or regulatory guidelines. These roles are often remote and offer flexible hours, but do not provide traditional employee benefits.
What are the key skills and qualifications needed to thrive as a utilization review 1099?
To thrive as a Utilization Review 1099 professional, you need a strong clinical background (often as a registered nurse or similar), experience with medical necessity criteria, and familiarity with insurance guidelines. Proficiency with utilization management software, electronic health records (EHRs), and knowledge of regulatory requirements are typically required, along with URAC or CCM certification being advantageous. Excellent analytical thinking, attention to detail, and effective communication skills are essential for collaborating with healthcare providers and payers. These skills ensure accurate, efficient review of patient care for coverage decisions, compliance, and cost-effective healthcare delivery.
What are some typical challenges faced by utilization review 1099 contractors, and how can they be managed?
Utilization Review professionals working as 1099 contractors often face challenges such as fluctuating caseloads, varying client requirements, and the need to stay current with changing regulations independently. Unlike full-time employees, contractors must also manage their own schedules, billing, and sometimes provide their own resources and training. To succeed, it's important to establish clear communication with clients, maintain up-to-date credentials, and leverage professional networks or continuing education resources to stay informed about industry changes.
What is the difference between Utilization Review 1099 vs Utilization Review Nurse?
| Aspect | Utilization Review 1099 | Utilization Review Nurse |
|---|---|---|
| Credentials | Varies; often self-employed or independent contractors | Registered Nurse (RN) license required |
| Work Environment | Remote or freelance; contract basis | Healthcare facilities, insurance companies, or clinics |
| Employer/Industry Usage | Freelance or independent consulting in healthcare | Hospitals, insurance providers, healthcare organizations |
| Work Focus | Reviewing medical necessity for insurance claims | Assessing patient records, making clinical decisions |
Utilization Review 1099 typically refers to independent contractors reviewing insurance claims, often working remotely. Utilization Review Nurse is a licensed RN performing clinical assessments within healthcare settings. While both roles involve utilization review, the 1099 role emphasizes independent contracting, whereas the nurse role requires clinical credentials and direct patient or clinical record involvement.
What are popular job titles related to Utilization Review 1099 jobs in Indiana?
For Utilization Review 1099 jobs in Indiana, the most frequently searched job titles are:
What job categories do people searching Utilization Review 1099 jobs in Indiana look for?
The top searched job categories for Utilization Review 1099 jobs in Indiana are:
- Discharge Planner Utilization Review
- Remote Hca Utilization Review
- Insurance Utilization Review
- Behavioral Utilization Review
- Optum Utilization Review
- Lpn Utilization Review Nurse
- Utilization Review Intake Coordinator
- Authorization Utilization Review Bcba
- Full Time Navihealth Utilization Review
- Flex Schedule Utilization Review
What cities in Indiana are hiring for Utilization Review 1099 jobs?
Cities in Indiana with the most Utilization Review 1099 job openings:
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 27 days ago
LifePoint Health rating
5.9
Based on 272 frontline employees who took The Breakroom Quiz
758th of 887 rated healthcare providers
Job description
Your experience matters
At Brentwood Springs , we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. In your role, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members. We believe that our collective efforts will shape a healthier future for the communities we serve.
What we offer
Fundamental to providing great care is supporting and rewarding our team. In addition to your base compensation, this position also offers:
- Health (Medical, Dental, Vision) and 401K Benefits for full-time employees
- Competitive Paid Time Off
- Employee Assistance Program - mental, physical, and financial wellness assistance
- Tuition Reimbursement/Assistance for qualified applicants
- And much more...
About Us
People are our passion and purpose. Brentwood Springs is a 48 bed hospital located in Newburgh, IN and is part of Lifepoint Health, a diversified healthcare delivery network committed to making communities healthier® with acute care, rehabilitation, and behavioral health facilities from coast to coast. From your first day to your next career milestone-your experience matters
How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to managed care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Qualifications and requirements
- Education: Bachelor's degree required. Master's degree preferred.
- Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
- License: Current unencumbered clinical license strongly preferred.
- Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred.
Essential Functions:
- Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
- Completes pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
- Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
- Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
- Works with DON to ensure documentation requirements are met.
- Ensure appeals are completed thoroughly and on a timely basis.
- Interface with managed care organizations, external reviews, and other payers.
- Communicate with physicians to schedule peer to peer reviews.
- Accurately report denials.
EEOC Statement:
Brentwood Springs is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
About Us
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
About the Team
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.
What LifePoint Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About LifePoint Health
Sourced by ZipRecruiter
Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Brentwood, TN, US
Year founded
1999