Utilization Review Jobs in USA

Pay Range:$73600.00 - $110400.00Please emailif you are a candidate seeking a reasonable accommodation for the application and/or interview process.At BCBSRI our greatest resource is our people.We come from varying backgrounds different cultures and unique experiences. We are hard-working caring and...

SummaryPerforms medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and review of medical claims and utilization...

Job Title: Intake Coordinator Department: NWITC Reports to: Intake Manager and/or DirectorFLSA Status: FTETS Range: 6/7 ($24.28)Opening Date: 7/10/2026Closing Date: 7/24/2026SUMMARY: The Intake Coordinator serves as a welcoming first point of contact for individuals families Tribal communities and r...

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 Bascom Palm...

IntroductionJoin our team as a Board-Certified Physician and take the lead in delivering expert medical care guiding teams and sharping the future of healthcare!The State of Connecticut Department of Correction (DOC) has exciting opportunities for Principal Physicians to join our team within the Hea...

The Ambulatory Clinical Pharmacy Manager provides clinical leadership to pharmacists pharmacy specialists residents and student interns within the Specialty Pharmacy Program in the Department of Pharmaceutical Care. This role primarily oversees pharmacists embedded within adult and pediatric multidi...

OverviewMonterey Park Hospital a 101-acute care facility located in the San Gabriel Valley of Los Angeles County is seeking an Office Coordinator for our Utilization Review Department. This is a full-time 8-hour day shift position reporting to the Chief Operating Officer.ResponsibilitiesThe Utilizat...

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...

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...

OverviewAt Crestwyn Behavioral Health Hospital your work does more than fill a shiftit changes lives. As a leading 80-bed behavioral health hospital in the Memphis area were dedicated to helping individuals overcome mental health and substance use challenges through compassionate evidence-based care...

Join us as a Utilization Review Clinician!Schedule: Monday - Friday 40 hours onsite. As a Utilization Review Clinician for MiraVista in Holyoke Massachusetts youll bring your experience and knowledge where your voice matters. A Utilization Review Clinician is an integral part of our multidisciplin...

Job DescriptionSaint Lukes Crittenton Childrens Center in South Kansas City MO is seeking a Supervisor of Behavioral Health Utilization Review to join our team. This role facilitates and directs the Utilization Review Department Case Management and Reception teams of a 24/7 inpatient residential and...

Excel. Empower. Advance. Shine. Belong. Explore. Flourish. Champion.Make It Happen At Hopkins!Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine one of the premier health delivery academic and research institutions in the United is a $2.5B b...

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

DescriptionPosition at Vassar Brothers Medical CenterNorthwell is the largest not-for-profit health system in the Northeast serving residents of New York and Connecticut with 28 hospitals more than 1000 outpatient facilities 22000 nurses and over 20000 physicians. Northwell cares for more than three...

DescriptionThe Case Manager (CM) will be responsible for all aspects of case management for an assigned group of patients to determine the appropriateness of the Level of Care assist in the development of the plan of care; ensure that the plan is implemented in a timely basis and identify the expect...

Overview:Monday - Friday DayshiftFull-Time 1.0 FTE Salary ExemptBenefits EligibleSchedule/Work Arrangement: Remote position with onsite attendance required for training meetings and other team needs. Fully on-site during the probationary period.The RN Care Coordinator - Intake (PFK) position serves...

DescriptionAre 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 w...

Title: Resource Utilization CoorDepartment Org: Outcome Management - 110040Employee Classification: B5 - Unclass Full Time AFSCME HSCBargaining Unit: AFSCME HSCPrimary Location: HSC HShift:1Start Time:7:00 am End Time:5:30 pmPosted Salary: $33.63 - $43.64Float: TrueRotate: TrueOn Call: TrueTravel: F...

Position SummaryThe Clinical Supervisor (CS) provides oversight leadership and direction to the clinical staff of Tandem Behavioral Health. This role ensures compliance with all federal state and local regulations promotes excellence in clinical care and maintains adherence to Virginia Medicaid and...