Experience with InterQual or MCG criteria, discharge planning, utilization review, and interdisciplinary care coordination.Knowledge of CMS regulations, Medicare and managed care requirements, and ...
Experience with InterQual or MCG criteria, discharge planning, utilization review, and interdisciplinary care coordination.Knowledge of CMS regulations, Medicare and managed care requirements, and ...
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
New
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
New
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
Experience with InterQual ® or MCG ® criteria, discharge planning, utilization review, and interdisciplinary care coordination. Knowledge of CMS regulations, Medicare and managed care requirements ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. OASIS experience ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
One (1) year of professional experience practicing as a Registered Nurse (RN) in home health or similar setting; previous case management/utilization review experience preferred. *OASIS experience ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
... utilization review experience preferred. • OASIS experience preferred. • Practical trach and/or ventilator experience preferred, not required. At Interim HealthCare, we know that being our best ...
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, PTO
Re-posted 10 days ago
Ascension Healthcare rating
7.0
Based on 1,039 frontline employees who took The Breakroom Quiz
414th of 887 rated healthcare providers
Job description
Your future role at a glance
Location: Evansville, IN
Facility: Ascension St. Vincent
Department/Specialty: Case Management
Schedule: Full Time | M-F 8am - 4:30pm | Weekend and Holiday rotation as needed
How you'll make an impact in this roleDesign Holistic Care Plans: Create personalized plans of care from admission to discharge that incorporate patient and family preferences, removing barriers to ensure smooth transitions across every stage of treatment.
Advocate for Patient Needs and Resources: Serve as a bridge between patients, multidisciplinary teams, and post-acute care providers, connecting families with vital resources to support long-term recovery.
Evaluate and Support Appropriate Levels of Care: Conduct ongoing clinical assessments to ensure patients receive the exact level of care they need while optimizing health plan benefits and clinical resource utilization.
Guide Multidisciplinary Collaboration: Maintain active, continuous communication with physicians, care transition teams, and payers to align on treatment plans and keep patient outcomes moving forward efficiently.
Licensure / Certification / Registration:
- Licensed Registered Nurse credentialed from the Indiana Board of Nursing obtained prior to hire date or job transfer date required.
- BLS Provider preferred. American Heart Association or American Red Cross accepted.
Education:
- Diploma from an accredited school/college of nursing OR required professional licensure at time of hire.
Three (3) or more years of recent acute care nursing experience.Two (2) or more years of hospital case management, utilization management, or care coordination experience preferred.Current ACM-RN, CCM preferred.Experience with InterQual or MCG criteria, discharge planning, utilization review, and interdisciplinary care coordination.Knowledge of CMS regulations, Medicare and managed care requirements, and post-acute care resources.
Life at Ascension: Where purpose meets opportunityAscension is a leading nonprofit Catholic health system with a culture and associate experience grounded in service, growth, care and connection. We empower our 97,000+ associates to bring their skills and expertise every day to reimagining healthcare, together. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter.
Equal employment opportunity employerEqual employment opportunity employer
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws. For further information, view the EEO Know Your Rights (English) poster or EEO Know Your Rights (Spanish) poster.
Fraud prevention notice
Prospective applicants should be vigilant against fraudulent job offers and interview requests. Scammers may use sophisticated tactics to impersonate Ascension employees. To ensure your safety, please remember: Ascension will never ask for payment or to provide banking or financial information as part of the job application or hiring process. Our legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system.
E-Verify statement
Employer participates in the Electronic Employment Verification Program. Please click here for more information.
BenefitsPaid time off (PTO)Various health insurance options & wellness plansRetirement benefits including employer match plansLong-term & short-term disabilityEmployee assistance programs (EAP)Parental leave & adoption assistanceTuition reimbursementWays to give back to your community
Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer.
Employment Type: FULL_TIMEWhat Ascension Healthcare employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Ascension
Sourced by ZipRecruiter
Ascension is a leading non-profit, faith-based national health system made up of over 150,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Industry
Health care and social assistance and outpatient health care
Company size
10,000+ Employees
Headquarters location
St. Louis, MO, US