• ABA Utilization Review ( UR

    Spectrum Billing Solutions (Skokie, IL)
    …and behavioral health treatment services. Utilization Review Specialist | Utilization Management Specialist | UR Specialist | Revenue Cycle ... streamlined manner. We are seeking to add an ABA Utilization Review ( UR ) Specialist... UR Specialist | Revenue Cycle Utilization Review Specialist | ABA… more
    Spectrum Billing Solutions (09/01/25)
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  • Utilization Review Specialist

    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...information and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff,… more
    BriteLife Recovery (09/02/25)
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  • PRN UR Clinical Specialist

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services ... and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
    Community Health Systems (09/18/25)
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  • Regional Utilization Review

    Trinity Health (Maywood, IL)
    …is Loyola campus. Position is hybrid, must reside in Illinois. The **Regional Utilization Review Documentation Specialist ** nurse works with the ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Utilization Review - RN Reviewer- Regional Coverage...coverage. The position includes but not limited to basic UR job duties such as level of care determination,… more
    Trinity Health (10/01/25)
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  • RN Utilization Review

    HonorHealth (AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job SummaryThe Utilization Review RN Specialist reviews and monitors utilization ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
    HonorHealth (09/10/25)
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  • Utilization Review Manager

    Minnesota Visiting Nurse Agency (Minneapolis, MN)
    *_SUMMARY:_* We are currently seeking a* Utilization Review Manager* to join ourTransitional Care Team.This is a full-time role and will be required to work ... this position: *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which include… more
    Minnesota Visiting Nurse Agency (09/30/25)
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  • RN Utilization Review Remote

    HonorHealth (AZ)
    …of communities across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors ... quality cost-effective care. Ensures appropriate level of care through comprehensive review for medical necessity of extended stay, outpatient observation, and… more
    HonorHealth (09/26/25)
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  • RN Care Manager (Inpatient) - 1.0 FTE

    St. Peters Health (Helena, MT)
    …coverage for discharge planning and utilization review over-site. 1. Utilization Review Specialist : receives information from the RN assigned to ... with the patient/family, physicians, and the interdisciplinary team, the Case Management/ Utilization Review RN facilitates the patient's progress through the… more
    St. Peters Health (09/20/25)
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  • Clinical Denials Prevention & Appeals…

    Nuvance Health (Danbury, CT)
    …at the time of review . If unable to resolve, escalate to the PA and Utilization Review ( UR ) Leadership. * Coordinate with the care team in changing ... behaviors to internal leadership for assistance in resolution. *Responsibilities:* * Review all inpatient admission and observation cases using InterQual, or… more
    Nuvance Health (09/26/25)
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  • Manager, Credentialing

    University of Rochester (Albany, NY)
    …time Scheduled Weekly Hours: 40 Department: 910397 URMC Medical Staff Services Work Shift: UR - Day (United States of America) Range: UR URG 112 Compensation ... compliance monitoring, including but not limited to, monitoring of health review requirements (OSHA), professional license, DEA, sanctions, NPDB, complaints, and… more
    University of Rochester (08/25/25)
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