Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Weekend availability is required; all applicants must be able to work at least one weekend day ...
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Atlanta, GA · Remote
$35 - $45.94/hr
We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Weekend availability is required; all applicants must be able to work at least one weekend day ...
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Augusta, GA · On-site
Website: The Utilization Review Clinician opportunity is a key member of the Lighthouse Case Management team who will integrate and coordinate clinical content with a keen focus on patient care ...
Atlanta, GA · On-site
$3.0K - $3.1K/wk
Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: * Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company ...
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Atlanta, GA · On-site
$3.0K - $3.1K/wk
Utilization Review Shift: 09:30 AM to 08:00 PM 13 weeks contract Description: * Utilization Review RN - Target Review * Health Plan Insurance (no acute care) * BLS (AHA) * RN state license Company ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
Responsibilities Utilization Review (UR) / Utilization Management (UM) Coordinator (Licensed Therapist or RN) The Utilization Review / Utilization Management Coordinator works closely with the other ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
The Director of Utilization Review is a key member of the Lighthouse Case Management Team who will integrate and coordinate a patient centric therapeutic strategy with a keen focus on clinical ...
Atlanta, GA · On-site
Utilization Review * Discipline: RN * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Requirements: Active RN license (State License required) BLS ...
Atlanta, GA · On-site
Utilization Review * Discipline: RN * Duration: 13 weeks * 40 hours per week * Shift: 8 hours, days * Employment Type: Travel Requirements: Active RN license (State License required) BLS ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN ...
Atlanta, GA · On-site
$49.77 - $57.70/hr
And more The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be ...
Atlanta, GA · On-site
$49.77 - $57.70/hr
And more The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN Preceptor must be ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN ...
And more Description The Clinical Utilization Review Nurse Preceptor (UR RN Preceptor) will be responsible for training, mentoring, and coaching for the Utilization Review Department. The UR RN ...
Perform the utilization and review process, for continued stay, in an appropriate and timely manner. * Maintain appropriate records of the review process for the purpose of preparing and submitting ...
Perform the utilization and review process, for continued stay, in an appropriate and timely manner. * Maintain appropriate records of the review process for the purpose of preparing and submitting ...
Responsibilities Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per Diem To coordinate and direct Utilization Review functions, monitoring the utilization and continuum ...
Responsibilities Coastal Harbor Health is currently seeking a Utilization Review Coordinator Per Diem To coordinate and direct Utilization Review functions, monitoring the utilization and continuum ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
The position combines utilization review, care coordination, insurance authorization management, and administrative oversight within behavioral health services. Location/Schedule: 3575 Fulton Mill ...
Weekend Utilization Review professionals typically work independently, reviewing patient cases for medical necessity, appropriateness of care, and compliance with payer guidelines during non-standard business hours. You will analyze patient charts, interact with clinical staff, and document findings, often collaborating remotely with other care coordinators or medical teams. While much of the role is desk-based, quick decision-making and effective communication are essential due to faster-paced weekend workflows. This schedule can offer greater autonomy and flexibility, but may also require prioritizing tasks and managing multiple cases efficiently to ensure continuous patient care.
A Weekend Utilization Review job involves assessing patient care and medical services during weekends to ensure they meet medical necessity and insurance guidelines. Professionals in this role review clinical documentation, coordinate with healthcare providers, and determine appropriate levels of care for patients. They typically work for hospitals, insurance companies, or other healthcare organizations. Strong analytical skills, medical knowledge, and familiarity with regulatory requirements are essential for success in this role.
Success as a Weekend Utilization Review professional requires a strong background in nursing or healthcare, critical thinking skills, and a thorough understanding of medical necessity criteria, such as InterQual or Milliman guidelines. Familiarity with electronic medical records (EMR) systems and utilization management software is highly beneficial, and RN or healthcare-related licensure is often required. Exceptional communication, attention to detail, and the ability to work independently on weekends are crucial soft skills. Mastering these areas allows efficient and accurate reviews of patient care, supporting optimal healthcare resource allocation outside of standard work hours.
$35 - $45.94/hr
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Posted 4 days ago
6.9
Based on 6 frontline employees who took The Breakroom Quiz
247th of 298 rated insurance
Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.
About the role:
You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.
You will report into the Supervisor, Utilization Review.
Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.
Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.
Responsibilities:
Requirements:
Bonus points:
This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.
At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.
Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.
Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.
Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.
California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.
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Sourced by ZipRecruiter
Insurance services
1,001 - 5,000 Employees
New York, NY, US
2012
