Utilization Review Jobs in USA

Job Title: Registered Nurse Case ManagementLocation: Apple Valley CAContract Duration: 13 WeeksSchedule: Day Shift 5x8 Hours 8:00 AM 4:30 PMOrientation: 40 Hours (Non-Billable)Position Overview:We are seeking an experienced Registered Nurse Case Manager for an Acute Care Facility in Apple Valley...

Job DetailsReviews payor denials and audits for potential lost revenue. Writes comprehensive factual arguments to present to third-party payers medical review boards or other responsible parties applying clinical criteria to establish medical necessity. Functions as a hospital liaison with external...

DescriptionYour experience mattersCopper Springsispart ofLifepoint Healtha diversified healthcare delivery network with facilities coast to coast. Weare driven by a profound commitment to prioritize your well-beingso you can provide exceptional care to others. As aTherapist joining our teamyoureembr...

Part-timeDescriptionStatus Hours:20 hrs/wkJob Summary:Cary Medical Center is seeking a detail-oriented and collaborative Discharge Analyst to join our team. This position plays a key role in coordinating monitoring reviewing and facilitating the timely and accurate discharge process for patients thr...

At Commence were the start of a new age of data-centric transformation elevating health outcomes and powering better more efficient process to program and patient health. We combine quality data-driven solutions that fuel answers technology that advances performance and clinical expertise that build...

Part-timeDescriptionStatus Hours:20 hrs/wkOnsite PositionJob Summary:Cary Medical Center is seeking a detail-oriented and collaborative Discharge Analyst to join our team. This position plays a key role in coordinating monitoring reviewing and facilitating the timely and accurate discharge process f...

At Commence were the start of a new age of data-centric transformation elevating health outcomes and powering better more efficient process to program and patient health. We combine quality data-driven solutions that fuel answers technology that advances performance and clinical expertise that build...

Part-timeDescriptionStatus Hours:20 hrs/wkOnsite PositionJob Summary:Cary Medical Center is seeking a detail-oriented and collaborative Discharge Analyst to join our team. This position plays a key role in coordinating monitoring reviewing and facilitating the timely and accurate discharge process f...

Investigation Coordinator IIEaston MD(Hybrid schedule with 2 days onsite)@Orchard LLC is retained by a not-for-profit corporation that partners with public and private sectors to create high quality safe and efficient delivery of health care and human services programs. We have multiple lines of bus...

Counselor - ResidentialReports To:Manager of Outpatient Counseling ServicesRequired Qualifications:Licensed Addictions Counselor (LAC) orLicensed Clinical Addictions Counselor (LCAC)One year addictions counseling experiencePreferred Qualifications:Licensed Master Addictions Counselor (LMAC)Two years...

Location:Greenspring Village by Erickson Senior LivingAre you a dynamic nursing leader with a passion for making a real impact Do you bring experience in Assisted Living and/or Memory Care supporting residents with cognitive impairment Are you energized by leading teams driving clinical excellence a...

Location:Greenspring Village by Erickson Senior Living****$5k SIGN-ON BONUS****Are you a dynamic nursing leader with a passion for making a real impact Do you bring experience in Assisted Living and/or Memory Care supporting residents with cognitive impairment Are you energized by leading teams driv...

Hourly Pay Range:$43.69 - $67.72 - The hourly pay rate offered is determined by a candidates expertise and years of experience among other factors.Position Highlights:Position: RN Patient Placement - HUB - Per DiemLocation: Northwest Community Hospital- Arlington Heights ILPer Diem - will need to wo...

DescriptionRegistered Nurse (RN) Behavioral Health House SupervisorJob Type: Full Time 5x8s or 4x10s Night Shift Weekends RequiredWage scale: $46.93 $65.70 per hourYour experience mattersLourdes Health is part of Lifepoint Health a diversified healthcare delivery network with facilities coast to...

Corewell Health is expanding its Utilization Management team and is seeking a collaborative and clinically driven Physician Advisor to support our East Region.Position OverviewThe Physician Advisor collaborates with the Utilization and Care Management Departments Organization Leadership as well as w...

Job OverviewThird-Party Administrator (TPA)We are seeking an experienced and compassionate Registered Nurse to join our team in a dynamic dual-role position combining Case Management and Utilization Review responsibilities within a Third-Party Administrator (TPA) environment.This role is ideal for a...

Travel Physical Therapist - Long Term Care (LTC) (Days)Mobile Health Team Inc. is seeking an experienced Physical Therapist - Long Term Care (LTC) for a 13-week travel assignment in Worchester MA.Contract DetailsDays 8hrStart Date: 6/22/2026Contract: 13 weeksLocation: Worchester MAHourly Pay: $ 33....

Travel Physical Therapist - Long Term Care (LTC) (Days)Mobile Health Team Inc. is seeking an experienced Physical Therapist - Long Term Care (LTC) for a 13-week travel assignment in Lowell MA.Contract DetailsDays 8hr;Start Date: 6/22/2026Contract: 13 weeksLocation: Lowell MAHourly Pay: $ 33.00Non-t...

Utilizing InterQual and other appropriate criteria responsible for reviewing all admissions and continued stay of patients in conformance with the established criteria set forth in the hospitals utilization management and quality assurance plan. Will determine the medical necessity for admission an...

Utilizing InterQual and other appropriate criteria responsible for reviewing all admissions and continued stay of patients in conformance with the established criteria set forth in the hospitals utilization management and quality assurance plan. Will determine the medical necessity for admission an...