Utilization Review Specialist
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
Tulsa, OK ยท On-site
The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to ... Maintains current knowledge of managed care requirements and accurately interprets these ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
JOB SUMMARY The Utilization Review (UR) has a well-developed knowledge and skills in the areas of ... The UR effectively and efficiently manages a diverse workload in a fast-paced, rapidly changing ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care opportunities for overall membership, institutionalized populations, high ...
Tulsa, OK ยท On-site
$66K - $81K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Tulsa, OK ยท On-site
$66K - $81K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Tulsa, OK ยท On-site
$69K - $85K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Quick apply
Tulsa, OK ยท On-site
$69K - $85K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
$69K - $85K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
$69K - $85K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Tulsa, OK ยท On-site
$69K - $85K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Tulsa, OK ยท On-site
$69K - $85K/yr
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Quick apply
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management expertise * Expanded credentials as an expert in Independent Medical Exams
Serve as an internal resource to provider services, contracting, claims, medical management ... example utilization review, quality improvement, clinical claims review). * Experience or ...
Serve as an internal resource to provider services, contracting, claims, medical management ... example utilization review, quality improvement, clinical claims review). * Experience or ...
Broken Arrow, OK ยท On-site
$19 - $25/hr
Cornerstone Specialty Hospitals Broken Arrow , located on the 3rd floor of Ascension St. John is a ... Experience in case management, utilization review, or discharge planning a plus.
Broken Arrow, OK ยท On-site
$19 - $25/hr
Cornerstone Specialty Hospitals Broken Arrow , located on the 3rd floor of Ascension St. John is a ... Experience in case management, utilization review, or discharge planning a plus.
The RN Case Manager delivers integrated nursing and case management services for individuals with ... Participate in quality improvement, utilization review, and outcome monitoring activities, to ...
The RN Case Manager delivers integrated nursing and case management services for individuals with ... Participate in quality improvement, utilization review, and outcome monitoring activities, to ...
$34.4K - $44.7K
9% of jobs
$52.3K is the 25th percentile. Wages below this are outliers.
$44.7K - $55K
22% of jobs
$55K - $65.3K
11% of jobs
The median wage is $71.7K / yr.
$65.3K - $75.6K
14% of jobs
$75.6K - $86K
12% of jobs
$92.4K is the 75th percentile. Wages above this are outliers.
$86K - $96.3K
13% of jobs
$96.3K - $106.6K
13% of jobs
$106.6K - $116.9K
5% of jobs
$116.9K - $127.2K
2% of jobs
$127.2K - $137.5K
0% of jobs
$137.5K - $147.8K
0% of jobs
$34.4K
$80.3K
$147.8K
| Aspect | Utilization Review Manager | Utilization Review Coordinator |
|---|---|---|
| Certifications | Typically requires certifications like CCM or ACU | May require similar certifications but often less advanced |
| Work Environment | Supervises review teams, manages processes in healthcare or insurance settings | Performs case reviews, supports the review process under supervision |
| Employer & Industry | Hospitals, insurance companies, healthcare organizations | Insurance companies, healthcare providers, third-party administrators |
The Utilization Review Manager oversees review teams and manages utilization review processes, focusing on policy compliance and efficiency. The Utilization Review Coordinator supports the review process by conducting case assessments and assisting managers. While both roles require similar certifications and work in related environments, the manager holds a supervisory position with broader responsibilities.
The most popular types of Utilization Review jobs in Tulsa, OK are:
For Utilization Review Manager jobs in Tulsa, OK, the most frequently searched job titles are:
The top searched job categories for Utilization Review Manager jobs in Tulsa, OK are:
Cities near Tulsa, OK with the most Utilization Review Manager job openings:

Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 12 days ago
Parkside provides professional purpose, hope, and healing. As a member of our staff, you will be part of a mission-driven team, dedicated to changing lives and changing communities, one patient at a time.ย
Parkside Psychiatric Hospital & Outpatient Clinic is a comprehensive mental healthcare system providing acute inpatient care, residential treatment, and outpatient therapy. With a focus on societyโs most vulnerable population, Parkside provides world-class mental health services for youth and adults. For over 65 years, Parksideโs physicians, therapists, and staff have providedย state of the art, patient-centered care that propels families from hopeful to hope-filled. As a center of excellence, we cultivate talent and provide professionalย purpose. Together weย facilitateย healing, one patient at a time.ย
We are looking for a Full Time Utilization Review Specialist! The Utilization Review Specialist asses, plans, implements and evaluates the internal processes to limit possible recoupment from third party pay sources including Medicare, Medicaid, HMO or private insurance. Coordinates with clinicians, business office and medical records to achieve above goals.
Responsibilities:
โข Prepares authorization paperwork, processes requests for authorizations, and reviews requests for accuracy.
โข Communicates with clinicians regarding discharge issues relevant to patientโs pay source. Tracks due dates for authorization reviews and alerts clinicians.
โข Communicates with clinicians regarding admissions and discharges to various units.
โข Knowledgeable of criteria for Medicare, Medicaid, HMO and private insurance coverage. Maintains current knowledge of managed care requirements and accurately interprets these requirements to increase authorizations.
โข Coordinates/completes the appeal process for authorization denials
โข Performs audits of clinical services to ensure compliance with standards of third party pay sources and agency policies.
โข Tracks unauthorized services and possible recoupment issues. Looks for possible corrections, trends.
ย โข Maintains a good working relationship within the department and with other departments.
โข Documentation meets current standards and policies.
ย โข Maintains fit for duty. Acts in a professional manner and follows all Parkside policies and procedures.
โข Orients new staff members to the unit
โข Demonstrates the ability to be organized and flexible, acts appropriately in stressful/emergency situations. Able to provide Handle with Care when needed
โข Performs other duties as assigned
Benefits include:
We are an Equal Opportunity Employer!ย