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JOB SUMMARY The Utilization Review Registered Nurse (RN) provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient servi

Nurses – are you looking for a change? Want to work no nights, no weekends, and no holidays? Be able to work from home 50% of the time once trained? Check out Hines & Associates ABOUT US: Hines is a

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offeri

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 me

Resp & QualificationsPURPOSE:Utilizing key principles of utilization management, the Utilization Review Specialist will perform prospective, concurrent and retrospective reviews for authorization, app

Job Type: Full-timeSchedule: Tuesday - Saturday OR Sunday - Thursday 8:00 AM – 5:00 PM (PST)Location: Anywhere in the US, Remote (California RN or LVN license required) Job SummaryMUST HAVE CALIFORNIA

Nashville General Hospital is hiring a Sr. Director of Patient Access and Utilization Management. Join our leadership team and make a lasting impact on patient care We are seeking an experienced and v

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and car

HoursShift Start Time:8 AM Shift End Time5 PM AWS Hours Requirement8/40 - 8 Hour Shift Additional Shift InformationWeekend Requirements:No Weekends On-Call RequiredNo Hourly Pay Range (Minimum - Midpo

As Physician Reviewer/Advisor you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the

At Zelis, we Get Stuff Done. So, let's get to it A Little About Us Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers. We serve more than 750 p

Overview$10.000 sign on bonus and $2.500 relocation (greater than 50 miles). - External Applicants Only.Under the general supervision of the Manager, Outpatient Community Services will serve as the Li

Anticipated End Date: Position Title: Utilization Management Representative IIIJob Description: Utilization Management Representative III Virtual: This role enables associates to work virtually

Job Title & Specialty Area: Perioperative Services Clinical Reviewer Department: Perioperative Services Location: Dallas Shift: Day, Mon - Fri Job Type: Hybrid (The schedule will be reviewed at time

Overview$10.000 sign on bonus and $2.500 relocation (greater than 50 miles). - External Applicants Only.Under the general supervision of the Manager, Outpatient Community Services will serve as the Li

Position SummaryForHealth Consulting at UMass Chan Medical School is seeking a detail-orientedNurse Reviewer IIwith experience caring for individuals with complex medical needs to join our Community C