Utilization Review Jobs in USA

Hours:Shift Start Time:8 AMShift End Time:5 PMAWS Hours Requirement:8/40 - 8 Hour ShiftAdditional Shift Information:Weekend Requirements:As NeededOn-Call Required:NoHourly Pay Range (Minimum - Midpoint - Maximum):$30.370 - $37.950 - $42.510The stated pay scale reflects the range that Sharp reasonabl...

DescriptionWestpark Springs-Behavioral Health Hospital Richmond TexasHouse Supervisor Registered Nurse (RN) Behavioral HealthJob Type: Full-time DaysYour experience mattersAt Mesa Springs we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to othe...

DescriptionTalent Pipeline / Future OpportunitiesHealthPartners is building a talent pipeline for Autism Care Manager BCBA professionals to support our Autism Care Management team. This posting is intended to identify and connect with qualified candidates for potential future opportunities across ou...

DescriptionPosition at Northwell HealthPART TIME- 20 hours per week- Mon-Fri 8pm- 12am shift- Rotating weekends and holiday coverage expected!Northwell is the largest not-for-profit health system in the Northeast serving residents of New York and Connecticut with 28 hospitals more than 1000 outpatie...

Medical Stop Loss Underwriting Practice Lead Accident & HealthWho we are:American International Group Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience today AIG member companies provide a wide range of property casualty insurance life insurance retirement s...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC your contributions matter and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% p...

Anticipated End Date:Position Title:Medical Director New York CommercialJob Description:Medical Director New York Commercial Location: This role enables associates to work virtually full-time with the exception of required in-person training sessions providing maximum flexibility and autonomy. Thi...

OverviewYou Matter Here!Heywood Healthcare values our employees! We offer competitive wages great benefits and generous earned time off. Come work where you will matter!Hours: Per Diem Days Evenings Weekends$38.00 - $57.48DisclaimerWe are committed to equitable and transparent compensation practices...

Psychiatric Mental Health Nurse Practitioner (Crisis / OSC Expedited Care)Community Bridges INCFront end/ Back end; Sunday Tuesday Rotating Wed 7AM-7PM; Rotating Wed Thursday Saturday 7AM-7PMFull Job DescriptionCommunity Bridges Inc. (CBI) is an integrated behavioral healthcare agency offering a v...

Psychiatric Mental Health Nurse Practitioner (Crisis / OSC Expedited Care)Community Bridges INCFront end/ Back end; Sunday Tuesday Rotating Wed 7AM-7PM; Rotating Wed Thursday Saturday 7AM-7PMFull Job DescriptionCommunity Bridges Inc. (CBI) is an integrated behavioral healthcare agency offering a v...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC your contributions matter and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% p...

Department InformationThis position is open to current Colorado residents onlyAbout Fort Logan:The Colorado Mental Health Hospital at Fort Logan (CMHHIFL) is one of two state hospitals serving our community. The vision of CMHHIFL is to provide the highest quality mental health services to persons wi...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC your contributions matter and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% p...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC your contributions matter and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% p...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC your contributions matter and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% p...

Job Description: Rx Claims SME Eden Prairie - MN; hybrid JD: 1. In depth knowledge on RxClaim Adjudication claims processing MedD claims 2. Deep knowledge of PBM concepts including drug pricing copays accumulators and Drug Utilization Review (DUR) 3. Knowledge on business & plan configuration...

Role: Rx Claims SME Location: Eden Prairie - MN; hybrid W2 Position Name Benefit Administration-PBM Pharmacy Claims...

DescriptionUtilization Review SpecialistYour experience matters:At Tampa General Behavioral Health Hospital we are committed to empowering and supporting a diverse and determined workforce who can drive quality scalability and significant impact across our hospitals and your role youll support thos...

OverviewOpportunities for you!Consecutively recognized as a top employer by Forbes and in 2025 by NewsweekVacation time starts building on Day 1 and builds with your seniorityFree money toward retirement with a 403(b) and matching contributionsGreat food options with on-demand orderingFree parking a...

Description Are you ready to bring your expert clinical skills to a world-class facility recognized as one of the top ten in the United States Do you have a passion for the highest quality and patient happiness Then please respond to this dynamic opportunity available with one of the best places to...