• Utilization Review Coordinator, (NY…

    New York State Civil Service (Buffalo, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), Greater Binghamton Health Center, P26033 Occupational Category ... Street City Buffalo State NY Zip Code 13904 Duties Description As a Utilization Review Coordinator, your duties will include:* Reviewing clinical records for… more
    New York State Civil Service (05/01/25)
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  • Utilization Review Coordinator, (NY…

    New York State Civil Service (Bronx, NY)
    NY HELP Yes Agency Mental Health, Office of Title Utilization Review Coordinator, (NY HELPS), New York City Children's Center - Bronx Campus, P25595 Occupational ... New York City Children's Center - Bronx Campus is recruiting for a Utilization Review Coordinator to analyze and evaluate quality, effectiveness, and efficiency… more
    New York State Civil Service (04/05/25)
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  • Case Manager (RN) - PRN Utilization

    Houston Methodist (The Woodlands, TX)
    …needs for the department and the hospital. **SERVICE ESSENTIAL FUNCTIONS** + Performs review for medical necessity of admission, continued stay and resource use, ... for the hospital. + Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care… more
    Houston Methodist (02/08/25)
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  • Registered Nurse Care Manager Utilization

    Catholic Health (Buffalo, NY)
    …Rotation Hours: 8:00 am to 4:00 pm Summary: The Registered Nurse (RN) Care Manager- Utilization Review , as an active member of the Care Management and ... interdisciplinary care team, provides comprehensive Utilization Review and discharge services to patients...in Case Management preferred EXPERIENCE + Two (2) years medical surgical nursing and/or job related experience + Preferred… more
    Catholic Health (05/01/25)
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  • Utilization Review Clinician…

    Centene Corporation (Columbia, SC)
    …and substance abuse preferred. Knowledge of mental health and substance abuse utilization review process preferred. Experience working with providers and ... for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering… more
    Centene Corporation (05/02/25)
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  • Physical Therapy Utilization Review

    Sedgwick (Salt Lake City, UT)
    …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Physical Therapy Utilization Review Advisor **For client coverage; prefer someone in ... updated with relevant industry regulations, guidelines, and best practices related to utilization review and maintains compliance with applicable laws and… more
    Sedgwick (04/24/25)
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  • Interim Director, Care Management…

    Trinity Health (Des Moines, IA)
    …**Shift:** **Description:** **_Are you an experienced Director of Care Management & Utilization Review looking for an interim assignment? Join Trinity Health ... $1300.00 Tax Free weekly Stipend or Trinity Health Pays Travel and Lodging._** **_ This is a non benefited...for the entire scope of Care Coordination for MercyOne Medical Center and MercyOne West Des Moines. Operational responsibilities… more
    Trinity Health (05/01/25)
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  • Utilization Management Reviewer I/II/III…

    Excellus BlueCross BlueShield (Utica, NY)
    …with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or otherwise ... position is responsible for coordinating, integrating, and monitoring the utilization of physical health (PH) medical and...regulatory and accreditation entities. Refers appropriate cases to the Medical Director for review . Refer to and… more
    Excellus BlueCross BlueShield (05/02/25)
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  • Utilization Management Operations Manager

    Tufts Medicine (Burlington, MA)
    …**Job Overview** The position provides day to day support and oversight to Utilization Review departments and UM vendor management. Responsible for compliance ... hours as needed. **Location:** Primarily remote. May require occasional travel to local facilities including Tufts Medical ...with CMS Conditions of Participation regarding Utilization Review and Discharge Planning including implementation… more
    Tufts Medicine (05/03/25)
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  • Organ Utilization Coordinator

    LifeCenter Northwest (Bellevue, WA)
    Organ Utilization Coordinator Job Details Job Location Bellevue - Bellevue, WA Position Type Full Time Salary Range $75918.00 - $110112.00 Salary Job Posting Date(s) ... Start Date 04/09/2025 Description and Qualifications The Organ Utilization Coordinator (OUC) is accountable for overseeing all activities related to the allocation… more
    LifeCenter Northwest (04/10/25)
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