Utilization Review Jobs in USA

Step Into a Role That Makes Care Transitions Smoother and Smarter!Our Mission: Quality compassionate care for all. Our Vision: Reimagine health care through connection service and innovation. Our Core Values: Be Kind Trust and Be Trusted Work Together Strive for Excellence.Logan Health Medical Ce...

Job DescriptionA career with a purpose in the community you love!Salt Lake County invites you to explore our exciting career opportunities. We seek highly enthusiastic individuals to enrich our County with your experience and talent. If you enjoy working in a team environment that is committed to ch...

Job Title: Registered Nurse Utilization ReviewLocation: Santa Rosa CAShift Details: Day Shift 5x8 Hours 08:00 AM 04:30 PM Contract Duration: 13 Weeks Orientation: 40 Hours (Non-Billable)Required QualificationsActive Registered Nurse (RN) License requiredMinimum 12 years acute care experience pre...

Job Title: Registered Nurse Utilization ReviewLocation: Santa Rosa CAShift Details: Day Shift 5x8 Hours 08:00 AM 04:30 PM Contract Duration: 13 Weeks Orientation: 40 Hours (Non-Billable)Required QualificationsActive Registered Nurse (RN) License requiredMinimum 12 years acute care nursing experi...

Job Title: Pharmacist Clinical Managed CareLocation: Portland ORShift Details: Day Shift 5x8 Hours 08:00 AM 05:00 PM Contract Duration: 26 Weeks Orientation: 40 Hours (Non-Billable Reduced Orientation Job) Schedule Notes: Rare weekend coverage (a few times per year)Required QualificationsPharmD...

**REDUCED Non-Billable Orientation (NBO) Job - 0 Hours NBO vs. Standard 40 NBO** OR WA or CA Pharmacist License Required 3 Years in a Managed Care Environment Required (meaning dealing with Prior Authorizations Audits Appeals ALJ Court hearings etc) **Rare weekends required a few times per year** RE...

Department:10107 Carolinas Rehabilitation: Charlotte - Compliance and IntegrityStatus: Part timeBenefits Eligible:NoHours Per Week:0Schedule Details/Additional Information:The PRN URC would not have a set schedule. The PRN URC would cover when teammates are out on PTO.Pay Range$35.50 - $53.25Major R...

OverviewNorthside Hospital is award-winning state-of-the-art and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a...

OverviewNorthside Hospital is award-winning state-of-the-art and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a...

Travel Registered Nurse-Inpatient Care Coordinator (Days/Nights)Mobile Health Team Inc. is seeking an experienced Registered Nurse-Inpatient Care Coordinator for a 13-week travel assignment in Sitka AK.Contract DetailsTues-Fri 10 hour shifts plus call - CirculatingStart Date: 6/8/2026Contract: 13 w...

Registered Nurse Clinical Auditor We are seeking a detail-oriented Registered Nurse to support medical record reviews billing compliance audits for the Indiana Health Coverage Programs. This role is responsible for evaluating the quality of care reviewing medical records and program policies and ide...

This is a remote position.Healthcare Data Analyst / Algorithm DeveloperPosition SummaryWe are seeking a detail-oriented Healthcare Data Analyst / Algorithm Developer to support healthcare data analysis coding logic development and program integrity activities for medical coding medical record rev...

Current Employees:If you are a current Staff Faculty or Temporary employee at the University of Miami please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position please review this tip sheet.The University of Miami has a great...

Title: RN Case Manager / Utilization Review / CDILocation: SyracuseState: New YorkDuration: 14 Weeks (High possibility of extension or permanent placement)Schedule: Day Shift Monday FridayShift Timing: 9:00 AM 5:30 PMWeekly Hours: 42.5 HoursPosition Overview:Navitas Healthcare LLC is seeking an...

SummaryThe Inpatient Nurse Care Manager in collaboration with the multidisciplinary team is responsible for assessing planning implementing and evaluating patients incorporating the clinical psychosocial and family factors specific to the care and disease management plan. Communicates and manages th...

DescriptionThe RN Manager Care Management provides leadership direction and resource management for case managers and social workers in the inpatient and ambulatory settings. The RN Manager effectively resolves utilization review and denial management issues provides leadership in resolving psychoso...

BENEFITS: At Bluestone we prioritize our employees and their wellbeing. We provide competitive benefit options to our employees and their families including domestic partners.Our offerings include:Starting salaryof $60000.Comprehensive health and Rx plans including a flat rate option.Wellness progra...

OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorshipand leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your caree...

Are you passionate about making a difference in peoples lives Do you enjoy working in a service-oriented industry If so this opportunity may be the right fit for you!Modivcare is looking for an experienced Facility Outreach Manager to join our this role you will serve as an advocate within the non-...

Are you passionate about making a difference in peoples lives Do you enjoy working in a service-oriented industry If so this opportunity may be the right fit for you!Modivcare is looking for an experienced Facility Outreach Manager to join our this role you will serve as an advocate within the non-...