West Lincoln, VT · On-site
$39.12 - $60.64/hr
... utilization reviews as required., Performs therapeutic procedures and treatments as ordered by the physician., Planning - Develops a plan that prescribes strategies to attain expected, measurable ...
West Lincoln, VT · On-site
$39.12 - $60.64/hr
... utilization reviews as required., Performs therapeutic procedures and treatments as ordered by the physician., Planning - Develops a plan that prescribes strategies to attain expected, measurable ...
West Lincoln, VT · On-site
$41.10 - $63.71/hr
Maintains records of in-services presented and employee attendance to assure any related government requirements are met., Participates in regular Utilization Reviews as required. Completes weekly ...
West Lincoln, VT · On-site
$41.10 - $63.71/hr
Maintains records of in-services presented and employee attendance to assure any related government requirements are met., Participates in regular Utilization Reviews as required. Completes weekly ...
Morrisville, VT · On-site
$25 - $30/hr
Conduct audits and chart reviews to ensure adherence to clinical guidelines and documentation standards. * Track utilization patterns to ensure appropriate use of healthcare services. * Develop and ...
Morrisville, VT · On-site
$25 - $30/hr
Conduct audits and chart reviews to ensure adherence to clinical guidelines and documentation standards. * Track utilization patterns to ensure appropriate use of healthcare services. * Develop and ...
$25 - $30/hr
Conduct audits and chart reviews to ensure adherence to clinical guidelines and documentation standards. * Track utilization patterns to ensure appropriate use of healthcare services. * Develop and ...
$25 - $30/hr
Conduct audits and chart reviews to ensure adherence to clinical guidelines and documentation standards. * Track utilization patterns to ensure appropriate use of healthcare services. * Develop and ...
Burlington, VT · On-site
$45.45 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Burlington, VT · On-site
$45.45 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Norwich, VT · On-site
$98K - $116K/yr
Monitor and forecast pharmacy cost and utilization trends for clients. Specifically analyze the ... Guide and review the work of junior analysts, fostering a culture of technical rigor and continuous ...
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Norwich, VT · On-site
$98K - $116K/yr
Monitor and forecast pharmacy cost and utilization trends for clients. Specifically analyze the ... Guide and review the work of junior analysts, fostering a culture of technical rigor and continuous ...
Job Seekers can review the Job Applicant Privacy Policy by clickinghere. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clickinghere. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clickinghere. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clickinghere. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clicking here. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clicking here. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clicking here. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Job Seekers can review the Job Applicant Privacy Policy by clicking here. : Eligible for a $2,000 ... This is done by maximum utilization of vehicles, controlling operational costs and an aggressive ...
Windsor, VT · On-site
$99K - $112K/yr
... utilization, and patient identification is overseen. 22. Completes monthly reports and formally reviews them with the facility administration. 23. Performs other related duties as required.
Windsor, VT · On-site
$99K - $112K/yr
... utilization, and patient identification is overseen. 22. Completes monthly reports and formally reviews them with the facility administration. 23. Performs other related duties as required.
Windsor, VT · On-site
$99K - $112K/yr
... utilization, and patient identification is overseen. * Completes monthly reports and formally reviews them with the facility administration. * Performs other related duties as required.
Windsor, VT · On-site
$99K - $112K/yr
... utilization, and patient identification is overseen. * Completes monthly reports and formally reviews them with the facility administration. * Performs other related duties as required.
Windsor, VT · On-site
$45.50 - $52/hr
... utilization, and patient identification is overseen. * Completes monthly reports and formally reviews them with the facility administration. * Performs other related duties as required.
Windsor, VT · On-site
$45.50 - $52/hr
... utilization, and patient identification is overseen. * Completes monthly reports and formally reviews them with the facility administration. * Performs other related duties as required.
Windsor, VT · On-site
$45.50 - $52/hr
... utilization, and patient identification is overseen. 22. Completes monthly reports and formally reviews them with the facility administration. 23. Performs other related duties as required.
Windsor, VT · On-site
$45.50 - $52/hr
... utilization, and patient identification is overseen. 22. Completes monthly reports and formally reviews them with the facility administration. 23. Performs other related duties as required.
Burlington, VT · On-site
$59.97 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Burlington, VT · On-site
$59.97 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Burlington, VT · On-site
$59.97 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Burlington, VT · On-site
$59.97 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Rutland, VT · On-site
$65K - $73K/yr
The overall goals are to reduce unnecessary Emergency Department utilization, assist in diverting ... For further information, please review the Know Your Rights notice from the Department of Labor.
Rutland, VT · On-site
$65K - $73K/yr
The overall goals are to reduce unnecessary Emergency Department utilization, assist in diverting ... For further information, please review the Know Your Rights notice from the Department of Labor.
Burlington, VT · On-site
$45.45 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
Burlington, VT · On-site
$45.45 - $74.48/hr
Concurrent utilization and service review, consultation, patient and family education, promotion of continuity of care, preceptorship and committee work are required at this level of practice.
South Burlington, VT · On-site
$39.95 - $59.93/hr
... Draft and review contract language in collaboration with legal counsel. • Maintain contract ... strategies based on utilization and payment trends. Network Strategy • Analyze network ...
South Burlington, VT · On-site
$39.95 - $59.93/hr
... Draft and review contract language in collaboration with legal counsel. • Maintain contract ... strategies based on utilization and payment trends. Network Strategy • Analyze network ...
Berlin, VT · On-site
$52.34 - $78.51/hr
Understanding of healthcare policy, reimbursement, and utilization management intersections with ... Review our benefit summary at: LEARN MORE What it's like working here: We Are CVMC: Find more ...
Berlin, VT · On-site
$52.34 - $78.51/hr
Understanding of healthcare policy, reimbursement, and utilization management intersections with ... Review our benefit summary at: LEARN MORE What it's like working here: We Are CVMC: Find more ...
$22.75 - $27.35
2% of jobs
$27.35 - $31.95
9% of jobs
$35.10 is the 25th percentile. Wages below this are outliers.
$31.95 - $36.55
21% of jobs
The median wage is $40.27 / hr.
$36.55 - $41.15
23% of jobs
$41.15 - $45.75
13% of jobs
$49.33 is the 75th percentile. Wages above this are outliers.
$45.75 - $50.35
10% of jobs
$50.35 - $54.95
8% of jobs
$54.95 - $59.55
5% of jobs
$59.55 - $64.15
5% of jobs
$64.15 - $68.75
2% of jobs
$68.75 - $73.35
2% of jobs
$22
$44
$73
A Utilization Review (UR) job involves assessing the medical necessity, efficiency, and appropriateness of healthcare services. UR professionals, often nurses or healthcare specialists, review patient records, insurance claims, and treatment plans to ensure they meet industry standards and payer requirements. They work with healthcare providers, insurance companies, and regulatory agencies to optimize care while controlling costs. Their goal is to balance quality patient care with cost-effective resource utilization.
A typical day in Utilization Review involves reviewing patient medical records, evaluating the necessity and appropriateness of proposed treatments or services, and documenting recommendations based on clinical criteria and insurance policies. Utilization Review specialists often collaborate closely with physicians, nurses, and insurance representatives to gather additional information and clarify cases. While much of the role is desk-based and may include remote work options, it requires regular communication with both clinical and administrative teams. This position offers variety and challenge, as no two cases are exactly alike, and there are often opportunities to advance into supervisory or quality improvement roles within the department.
To thrive in Utilization Review, professionals typically need a background in nursing or healthcare, strong clinical assessment capabilities, and a thorough understanding of medical guidelines and insurance regulations. Familiarity with electronic medical records (EMR) systems and utilization management software, and often certification such as Certified Utilization Review Specialist (CURN), are important. Excellent critical thinking, attention to detail, and strong communication skills enable effective case evaluation and collaboration with healthcare teams. These skills and qualifications ensure objective, accurate decisions that support cost-effective, quality patient care within compliance standards.
The most popular types of Utilization Review jobs in Vermont are:
For Utilization Review jobs in Vermont, the most frequently searched job titles are:
The top searched job categories for Utilization Review jobs in Vermont are:
Cities in Vermont with the most Utilization Review job openings:
$39.12 - $60.64/hr
Full-time
Posted 17 days ago
Internal Employees: Please ensure that you are logged into Workday and applying through the Jobs Hub before proceeding.
RN (Home Care)Job Description
Registered Nurse is responsible for providing nursing care in accordance with state licensure status and in compliance with policies and procedures, applicable health care standards and governmental laws and regulations.
Hours: Day-time hours, weekend, holiday, and on-call rotation
Requirement: Active RN in the State of IL, Driver's license
Responsibilities
Assessment- Collects pertinent data and information relative to the patient's health or the situation. Recognizes normal and abnormal findings when gathering data., Coordination of Care- Plans and evaluates care in collaboration with appropriate disciplines for assigned patients., Diagnosis - Analyzes assessment data to determine actual or potential diagnosis, problems, and issues., Evaluation- Evaluates progress toward attainment of goals and outcomes. Reports data and outcomes to as appropriate to physician and/or other disciplines., Implementation - Implements care and supervises care delivered by other team members in alignment with the plan of care and approved safety and infection control standards., Knowledge - In collaboration with Leader/Director, actively pursues required knowledge and skills through orientation activities specific to the unit, unit based in-service programs, reading current literature and seeking new clinical learning opportunities., Other duties as assigned to assist with overall operations of the agency., Outcomes Identification - Identifies expected outcomes for a plan individualized to the patient or situation., Participates as a member of Health System committees, community organizations and professional associations as requested., Participates in regular utilization reviews as required., Performs therapeutic procedures and treatments as ordered by the physician., Planning - Develops a plan that prescribes strategies to attain expected, measurable outcomes., Prepares and submits documentation of client assessments, summaries, CPSA, case conferences, and progress notes according to policy., Provides skills assessments of patient/family needs, physical and emotional conditions, and responses to the POC and CP., Provides supervision for LPN, Aide staff as required by job duties in accordance to state and federal regulations., Relationships - Establishes effective working relationships with peers, physicians, and other members of the health care team. Identifies and confers with appropriate resources regarding patient care decisions., Teaching - Employs teaching strategies to promote health and a safe environment.Requirements
ADN (Required)Automobile Insurance - Sarah Bush Lincoln, BLS or CPR certification (within 90 days of hire) - Sarah Bush Lincoln, Driver's License - State of Illinois, RN-Registered Nurse - Illinois Department of Financial and Professional RegulationCompensation
Estimated Compensation Range
$39.12 - $60.64Pay based on experience
