JOIN OUR TEAM AS A Administrative Assistant - Utilization Review - Part Time Your Work Matters How ... Our compassionate and experienced team of psychiatrists, licensed therapists, nurses and support ...
JOIN OUR TEAM AS A Administrative Assistant - Utilization Review - Part Time Your Work Matters How ... Our compassionate and experienced team of psychiatrists, licensed therapists, nurses and support ...
Administrative Assistant for Utilization Review
Waukegan, IL · On-site
$19 - $26/hr
JOIN OUR TEAM AS A Administrative Assistant - Utilization Review - Part Time Your Work Matters How ... Our compassionate and experienced team of psychiatrists, licensed therapists, nurses and support ...
Administrative Assistant for Utilization Review
Waukegan, IL · On-site
$19 - $26/hr
JOIN OUR TEAM AS A Administrative Assistant - Utilization Review - Part Time Your Work Matters How ... Our compassionate and experienced team of psychiatrists, licensed therapists, nurses and support ...
RN, Denials Management
Menomonee Falls, WI · On-site
$36.38 - $56.39/hr
Assists the case managers with utilization review issues, and provides recommendations for process ... A minimum of 5 years of acute care nursing experience or 5 years nursing with relevant denials ...
RN, Denials Management
Menomonee Falls, WI · On-site
$36.38 - $56.39/hr
Assists the case managers with utilization review issues, and provides recommendations for process ... A minimum of 5 years of acute care nursing experience or 5 years nursing with relevant denials ...
RN, Denials Management
Menomonee Falls, WI · On-site
$36.38 - $56.39/hr
Assists the case managers with utilization review issues, and provides recommendations for process ... A minimum of 5 years of acute care nursing experience or 5 years nursing with relevant denials ...
RN, Denials Management
Menomonee Falls, WI · On-site
$36.38 - $56.39/hr
Assists the case managers with utilization review issues, and provides recommendations for process ... A minimum of 5 years of acute care nursing experience or 5 years nursing with relevant denials ...
RN DENIALS MANAGEMENT HOURLY
Milwaukee, WI · On-site
$36.38 - $56.39/hr
Assists the case managers with utilization review issues, and provides recommendations for process ... Professional knowledge of nursing theory and practice at a level normally acquired through ...
RN DENIALS MANAGEMENT HOURLY
Milwaukee, WI · On-site
$36.38 - $56.39/hr
Assists the case managers with utilization review issues, and provides recommendations for process ... Professional knowledge of nursing theory and practice at a level normally acquired through ...
Assists the case managers with utilization review issues, and provides recommendations for process ... Professional knowledge of nursing theory and practice at a level normally acquired through ...
Assists the case managers with utilization review issues, and provides recommendations for process ... Professional knowledge of nursing theory and practice at a level normally acquired through ...
... from Utilization Review and other areas. * Participates in and leads, as necessary ... Registered Nurse Case Manger Minimum Requirements: * RN Wisconsin license * 3-5 years of hospital ...
... from Utilization Review and other areas. * Participates in and leads, as necessary ... Registered Nurse Case Manger Minimum Requirements: * RN Wisconsin license * 3-5 years of hospital ...
The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ... Bachelor's degree in nursing from an accredited college or university, with at least five (5) years ...
The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ... Bachelor's degree in nursing from an accredited college or university, with at least five (5) years ...
The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ... Bachelor's degree in nursing from an accredited college or university, with at least five (5) years ...
The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ... Bachelor's degree in nursing from an accredited college or university, with at least five (5) years ...
The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ... Bachelor's degree in nursing from an accredited college or university, with at least five (5) years ...
The CRS also reviews reimbursement systems for PDPM and Case Mix to ensure accurate and optimized ... Bachelor's degree in nursing from an accredited college or university, with at least five (5) years ...
Oversee the discharge planning process , working closely with physicians, nurses, and other healthcare professionals to ensure smooth transitions. * Perform utilization review to assess medical ...
Oversee the discharge planning process , working closely with physicians, nurses, and other healthcare professionals to ensure smooth transitions. * Perform utilization review to assess medical ...
Case Manager Full Time and PRN
Waukegan, IL · On-site
$36 - $55/hr
Oversee the discharge planning process , working closely with physicians, nurses, and other healthcare professionals to ensure smooth transitions. * Perform utilization review to assess medical ...
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Case Manager Full Time and PRN
Waukegan, IL · On-site
$36 - $55/hr
Oversee the discharge planning process , working closely with physicians, nurses, and other healthcare professionals to ensure smooth transitions. * Perform utilization review to assess medical ...
Case Manager Full Time and PRN
Waukegan, IL · On-site
$36 - $55/hr
Oversee the discharge planning process , working closely with physicians, nurses, and other healthcare professionals to ensure smooth transitions. * Perform utilization review to assess medical ...
Case Manager Full Time and PRN
Waukegan, IL · On-site
$36 - $55/hr
Oversee the discharge planning process , working closely with physicians, nurses, and other healthcare professionals to ensure smooth transitions. * Perform utilization review to assess medical ...
... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Valid RN nursing license in the state of Wisconsin Apply now and we can discuss further!
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... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Valid RN nursing license in the state of Wisconsin Apply now and we can discuss further!
... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Director of Nursing (DON) * A minimum of 2-3 years' management experience * A team player with ...
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... and Utilization Review/PPS. * Meets with committee members to evaluate activities within the ... Director of Nursing (DON) * A minimum of 2-3 years' management experience * A team player with ...
Locum Physician (MD/DO) - Family Practice in Waupun, WI
Milwaukee, WI · On-site
$155/hr
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
Locum Physician (MD/DO) - Family Practice in Waupun, WI
Milwaukee, WI · On-site
$155/hr
... nursing, mental health, administrative, and security teams * Participate in quality assurance, peer review, and performance improvement activities * Address clinical risk management, utilization ...
Registered Nurse Clinical Manager
West Allis, WI · On-site
$77K - $106K/yr
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Registered Nurse Clinical Manager
West Allis, WI · On-site
$77K - $106K/yr
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Registered Nurse Clinical Manager
Racine, WI · On-site
$77K - $106K/yr
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Registered Nurse Clinical Manager
Racine, WI · On-site
$77K - $106K/yr
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
As a Registered Nurse Clinical Manager , you will: * Oversee clinical operations for the location ... Conduct ongoing staff education based on documentation review, utilization review findings, and ...
Utilization Review Nurse information
See Racine, WI salary details
$20.06 - $24.12
2% of jobs
$24.12 - $28.18
9% of jobs
$30.95 is the 25th percentile. Wages below this are outliers.
$28.18 - $32.23
21% of jobs
The median wage is $35.52 / hr.
$32.23 - $36.29
23% of jobs
$36.29 - $40.35
13% of jobs
$43.50 is the 75th percentile. Wages above this are outliers.
$40.35 - $44.40
10% of jobs
$44.40 - $48.46
8% of jobs
$48.46 - $52.52
5% of jobs
$52.52 - $56.58
5% of jobs
$56.58 - $60.63
2% of jobs
$60.63 - $64.69
2% of jobs
$20
$39
$64
How much do utilization review nurse jobs pay per hour?
How to make $300,000 as a nurse?
What are the key skills and qualifications needed to thrive as a Utilization Review Nurse, and why are they important?
What does a Utilization Review Nurse do?
What are some typical challenges Utilization Review Nurses face when communicating with healthcare providers and insurance companies?
What Does a Utilization Review Nurse Do?
A utilization review nurse determines the best course of treatment for a patient using preapproved policy criteria. Utilization review nurses collect and review patient records, clinical documentation, and billing information to recommend the best use of patient care resources. Their assessments help determine the length of hospital stays, the effectiveness of the care plan, and the necessity of the services administered. Utilization review nurses inform and educate patients about their options based on their insurance benefits and limitations. Utilization review nurses also assess patient care services in clinical appeals for approval or denial.
What does a nurse do in a utilization review?
How to get into utilization review as a nurse?
What is the difference between Utilization Review Nurse vs Case Manager?
| Aspect | Utilization Review Nurse | Case Manager |
|---|---|---|
| Credentials | RN license, certification in utilization review (e.g., URAC) | RN license, case management certification (e.g., CCM) |
| Work Environment | Hospitals, insurance companies, healthcare facilities | Hospitals, insurance companies, community health settings |
| Employer & Industry Usage | Primarily in insurance and healthcare organizations for reviewing medical necessity | In healthcare and insurance for coordinating patient care and discharge planning |
Utilization Review Nurses focus on evaluating the necessity and appropriateness of medical services, often working in insurance or healthcare settings. Case Managers coordinate patient care, discharge planning, and resource management. While both roles require RN licensure and related certifications, their primary responsibilities differ: UR Nurses review medical necessity, whereas Case Managers facilitate patient care and services.
Is it hard to be a utilization review nurse?

$19 - $26/hr
Part-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 11 days ago
Job description
JOIN OUR TEAM AS A Administrative Assistant – Utilization Review – Part Time
Your Work Matters How will you make a difference?
The Administrative Assistant is responsible for providing administrative support for the Utilization Management department, including performing clerical duties, attending departmental meetings, coordinating staff activities, staff educational files and providing support for the Director of Clinical Programming.
Schedule: Monday – Friday flexiable hours ( 8am–1pm) or Monday – Thursday (8am- 2pm)
Your Experience Matters What we’re looking for:
- Education: Associate Degree in Business Administration or related field preferred; or an equivalent combination of education and experience.
- Experience: At least one (1) year experience as an Administrative Assistant in a health care setting   preferred in a health care setting; or combination of education, training and experience.
- Additional Requirements: Must be able to type at least 65 w.p.m.; knowledge of Word and Excel software programs; and experience as a mental health technician desired. Ability to work overtime and flexible hours, as requested.
PRIMARY RESPONSIBILITIES
Primary duties may include, but are not limited:
- Completes frontline and clerical support to the Utilization Review team in processing daily, weekly, and monthly reports
- Managing incoming calls or incoming emails from insurance companies and route them appropriately.
- Follow-up on appeal submissions to determine status.
- Develops and maintains positive customer relations and coordinates with various functions within the company to ensure clinical requests and questions are handled appropriately and in a timely manner.
- Verify patient insurance eligibility as needed
- Complete follow-up calls for Utilization Review Coordinators to maintain compliance on authorization timeframes.
- Provide support for documentation uploads of authorizations.
- Troubleshoot for missing documentation as requested.
- Responds to tasks and written request from coordinators, providers and internal departments.
- Open and distribute mail for the department.
- Order supplies for the department, maintain a cost-effective and efficient office.
- Consistently prioritize workloads to ensure daily work is completed.
- Adhere to facility, department and Corporate Personnel Policies and Procedures.
Your Care Matters What we provide for our team:
- 401(k) + matching
- Health insurance
- 100% company-paid life insurance coverage up to 2x your annual salary
- Vision insurance
- Dental insurance
- 100% company-paid long term disability insurance
- Paid time off
- Cafeteria on site + discounted meals
- Employee engagement events
- Employee assistance program
- Employee recognition program
- Free parking
What sets us apart:
- Career & training development opportunities
- Dynamic and inclusive work environment
- Engaged management team dedicated to your success
- A guiding mission and set of values that serve as both our north star and yours, anchoring our collective purpose and aspirations
Disclaimer: Benefits are subject to change at the discretion of Lake Behavioral Hospital.
Compensation:
This is a Part-Time role and the expected compensation range for this role is $19.00 -$26.00 hourly.  We’re eager to engage with all qualified candidates, and consideration will be provided to experience and skill level. Join us as our Administrative Assistant for Utilization Review.
Get to know us Outstanding Care, Compassionate People, Unparalleled Service
Discover a fulfilling career at Lake Behavioral Hospital (LBH)!
We are a 161-bed acute care facility located in Waukegan, IL and has been providing mental health treatment to the community and the state of Illinois since 2018. We are dedicated to offering services to meet the ever-changing emotion and behavioral healthcare needs of adolescents, adults, and their families. We offer specialized inpatient programs and outpatient services proven to decrease symptoms of mental illness and we are committed to help people live healthier lives. Our compassionate and experienced team of psychiatrists, licensed therapists, nurses and support staff are here to create an atmosphere of health, hope, and healing.
Join us in providing exceptional care and contributing to the well-being of individuals and families in need, and be a part of the transformative healthcare experience at Hospital for Behavioral Medicine.
- To learn more about LBH, visit us at: https://www.lakebehavioralhospital.com/
TOGETHER WE CAN MAKE POSITIVE I.M.P.A.C.T.S.
Individuals Maintaining Positive Attitude and Commitment To Service
____________________________________________________________
At Lake Behavioral Hospital, we value a diverse, inclusive workforce and provide equal employment opportunities for all applicants and employees. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, gender identity or expression, age, marital status, veteran status, disability status, pregnancy, parental status, genetic information, political affiliation, or any other status protected by the laws or regulations in the locations where we operate. Accommodations are available for applicants with disabilities.
About Lake Behavioral Hospital
Sourced by ZipRecruiter
Industry
Offices of mental health practitioners
Company size
51 - 200 Employees
Headquarters location
Waukegan, IL, US
Year founded
2018