Utilization Review Jobs

Position Summary:The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital Utilization Review Program and makes...

Job SummaryThe Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports...

Position Summary:The Utilization Review Specialist/Outcomes Specialist conducts concurrent and retrospective review functions in support of the hospital Utilization Review Program and makes...

A highly awarded health system located north of Philadelphia, Pennsylvania, is seeking a Family Medicine physician to work in a non-clinical utilization review setting.?Opportunity Highlights...

A highly awarded health system located north of Philadelphia, Pennsylvania, is seeking an Emergency Medicine physician to work in a non-clinical utilization review setting.?Opportunity Highlights...

Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture...

Job SummaryThe Utilization Review (UR) Nurse has acute knowledge and skills in areas of utilization management (UM), medical necessity, and patient status determination. This individual supports...

OverviewThe Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the...

JOB SUMMARY Responsible for the Utilization Management process (Admission, Continued Stay and Discharge Reviews) which include evaluating medical information to determine medical necessity and...

Job Summary / PurposeResponsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants,...

Responsible for accurately transposing and reconciling clinical documentation from the EMR into the payer specific systems to provide information for proper risk adjustment of patients and increase...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization...

OverviewThe Senior Utilization Review Physician Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the...

JOB SUMMARY Responsible for the Utilization Management process (Admission, Continued Stay and Discharge Reviews) which include evaluating medical information to determine medical necessity and...

Job Summary / PurposeResponsible for the review of medical records for appropriate admission status and continued hospitalization. Works in collaboration with the attending physician, consultants,...

Responsible for accurately transposing and reconciling clinical documentation from the EMR into the payer specific systems to provide information for proper risk adjustment of patients and increase...