Utilization Review Jobs in USA

HelloThank you for your interest in career opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job application:Provide all of your employment history education and licenses/certifications/registrations. You will be unable...

Job Requisition ID:56870BPIS: 10936Opening Date: 06/23/2026Closing Date: 07/08/2026Agency: Department of Healthcare and Family ServicesClass Title:SENIOR PUBLIC SERVICE ADMIN (40070)Skill Option:Special License - Registered Nurse LicenseBilingual Option:NoneSalary: Anticipated salary range $10000-$1...

Job Summary: We seek a highly skilled and experienced Registered Nurse with specialties in Medical/Surgical ICU ER Psychiatric Labor & Delivery PACU Operating Room. The Registered Nurse will be responsible for providing skilled nursing care case management and hospice care to individuals facing adva...

House Supervisor (Registered Nurse) Night Shift Location: Belle Mead NJ Clinic: Behavioral Health On-Call: Required Commitment Holidays: Must work 4 of 6 designated holidays Position Summary We are seeking an experienced House Supervisor (RN) to provide leadership and operational oversight in a ho...

This position is responsible for: Routine case management discharge planning swing bed coordinator and utilization review duties. Evaluating and screening potential admissions to the facilities swing bed program knowledgeable of criteria for Medicare Medicaid HMO swing bed and private insurance cove...

This position is responsible for: Routine case management discharge planning swing bed coordinator and utilization review duties. Evaluating and screening potential admissions to the facilities swing bed program knowledgeable of criteria for Medicare Medicaid HMO swing bed and private insurance cove...

This position is responsible for:Routine case management discharge planning swing bed coordinator and utilization review and screening potential admissions to the facilities swing bed programknowledgeable of criteria for Medicare Medicaid HMO swing bed and private insurance coverageInitiate ongoing...

Job Title: Physical Therapist Assistant (PTA) Facility: Worcester Rehabilitation & Health Care Center Address: 119 Providence St Worcester MA 01604 Contract: 13 Weeks Shift: 8 hr days Pay: $40/hr (W2) $43/hr (1099) Job Description Utilizes evidence-based practice to support clinic...

Job Title: Claims Representative - Liability Location (On-site Remote or Hybrid): Charlotte NC (remote) Contract Duration: Contract until 08/21/2026 Note: Any specific skill/ certification/ experience: 3-4 years bodily injury claims low exposure up to 25K Years of experience: 3-4years PRIMARY P...

The Social Worker Discharge Planning reflects the mission vision and values of NM adheres to the organizations Code of Ethics and Corporate Compliance Program and complies with all relevant policies procedures guidelines and all other regulatory and accreditation standards.The Social Worker is respo...

ID: Shift: Day 5x8-Hour (09:00 - 17:00) Description: Required Certs: BLS and CA LicensePreferred Certs: BSN or MSNRequired Skills: Utilization review care coordination acute hospital ER/ICU audits data abstraction quality improvement HIPAA Joint Commission preparationRequired experience: 5 years -...

ID: Shift: Day 5x8-Hour (09:00 - 17:00) Description: Required Certs: BLS and CA LicensePreferred Certs: BSN or MSNRequired Skills: Utilization review care coordination acute hospital ER/ICU audits data abstraction quality improvement HIPAA Joint Commission preparationRequired experience: 5 years -...

Scope of workProvides health information interacts and acts as a resource for providers for complex clinical situations to ensure appropriate use of preservice and concurrent acute medical and/or behavioral health care services. Assesses appropriateness of preservice and concurrent requests for admi...

OverviewJOB SUMMARY: The Case Manager P.T. facilitates patient admission from outside referrals provides on-site evaluation and provides ongoing communication to the external case manager on the progress of the patient. He/She assures that each patient is appropriate for admissions and writes treatm...

Job Family:Patient Access GeneralTravel Required:NoneClearance Required:NoneWhat You Will Do:The Patient Access Representative Notification of Admission Specialist supports Guidehouses healthcare revenue cycle operations by completing accurate timely payer notifications for inpatient and observatio...

DescriptionTitle: Therapist Inpatient Adolescent ProgramJob Type: Full timeSchedule: Monday- Friday 8 am- 4 pmYour experience matters!At Woodland Springs we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here youre not just valued as...

ID: Shift: Day 5x8-Hour (08:00 - 16:30) Description: MUST HAVE STRONG ED ExperienceMUST HAVE STRONG INTERQUAL ExperienceHigh volume ED looking for strong candidate*4x10H schedule can be considered Modified Time:7/13/2026 7:00:00 AM Account Manager: Haley Dollard Account Manager Email: COVID-19 Vac...

The Director Managed Care Services & Vendor Management is responsible for the strategic oversight operational performance and continuous improvement of all medical management programs within MEMIC. This role leads internal clinical teams and manages external medical management vendors to ensure high...

HelloThank you for your interest in career opportunities with the University of Mississippi Medical Center. Please review the following instructions prior to submitting your job application:Provide all of your employment history education and licenses/certifications/registrations. You will be unable...

The Case Manager is a qualified registered nurse with the ability to provide and oversee the care of assigned patients and associated staff in accordance with physician orders and the plan of care per state Practice this role you will report to the Director of Nursing/Director of Patient Care Servi...