- Spectrum Billing Solutions (Skokie, IL)
- …in the most efficient and streamlined manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA UR Specialist ... software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR… more
- BriteLife Recovery (Englewood, NJ)
- What you will be doing? The Utilization Review (UR) Specialist is a critical member of the administrative team at Advanced Revenue Solutions and is responsible ... for overseeing and coordinating all aspects of utilization review and insurance authorization for clients receiving substance use disorder (SUD) treatment at… more
- HonorHealth (AZ)
- …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization of ... of extended stay, outpatient observation, and inpatient stays and the utilization of ancillary services. Responsible for coordinating and conducting medical… more
- CaroMont Health (Gastonia, NC)
- …liaison to managed care organizations. Communicates with attending physicians regarding utilization issues. Collaborates with discharge planning specialist and ... with managed care organizations when requested. Assesses for best utilization regarding level of patient care, diagnostic testing, and...clinical reviews/appeals as part of denial process. The UR Specialist will be cross trained to work for the… more
- YesCare Corp (Brentwood, TN)
- …best possible health outcome. + Assist in the control of utilization of resources, pre-occurrence monitoring, concurrent monitoring, intervention and retrospective ... quality health care intervention recommendations. + Review and assess over/under utilization issues. + Track, trend and evaluate appropriateness and quality of… more
- AnMed Health (Anderson, SC)
- …This position is responsible for performing the daily operations of the Utilization Management program at AnMed within the Care Coordination model. These duties ... continued stay/concurrent review, retrospective review, bed status management, resource utilization management, regulatory compliance, and related denial management issues.… more
- TEKsystems (Canoga Park, CA)
- …experienced RN or LVN with an active license to join our team as a Utilization Review Nurse. In this role, you will conduct retrospective reviews of inpatient and ... within a managed care environment. Key Responsibilities + Perform comprehensive utilization reviews for inpatient and outpatient claims. + Prepare medical records… more
- TEKsystems (Canoga Park, CA)
- Position: Utilization Review Nurse Work Enviroment: Hybrid work schedule Schedule: Full time position, Flexible start time of 7-8 am, 5 days x 8hrs , no weekends, ... processing in a managed care environment. Key Responsibilities: + Perform detailed utilization reviews for inpatient and outpatient claims. + Prepare medical records… more
- TEKsystems (Canoga Park, CA)
- …Vocational Nurse (LVN) or Registered Nurse (RN) with hands-on experience in Utilization Management (UM) and a strong understanding of HMO/Medicare claims processes. ... + Active LVN or RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims, audits, and denials +… more
- UnityPoint Health (Cedar Rapids, IA)
- …Treatmt/Child S + Shift: 0900-1700 + Job ID: 174223 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments ... care, optimal clinical outcomes and patient and provider satisfaction. The UM Specialist provides the Utilization Management function for patients admitted to… more