• Clinical Utilization Review

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
    Community Health Systems (09/03/25)
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  • Utilization Review Specialist

    BayCare Health System (Tampa, FL)
    …of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior responsibilities include:** + Functions ... more Equal Opportunity Employer Veterans/Disabled **Position** Utilization Review Specialist Sr. **Location** Tampa:St Josephs | Clinical | Full Time… more
    BayCare Health System (08/26/25)
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  • Clinical Revenue Specialist - Case…

    Montrose Memorial Hospital (Montrose, CO)
    …provided. This position combines the unique skill sets of the Utilization Review Nurse and Clinical Documentation Specialist to facilitate documentation ... patient. About The Career: + The purpose of the Clinical Revenue Specialist position is to ensure...experience preferred; and one (1) to two (2) years Utilization Review experience preferred. What We Offer:… more
    Montrose Memorial Hospital (08/20/25)
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  • ABA Utilization Review (UR)…

    Spectrum Billing Solutions (Skokie, IL)
    …Excel, billing software). + Understanding of mental and behavioral health treatment services. Utilization Review Specialist | Utilization Management ... will utilize his or her knowledge and skills to review clinical information and obtain initial and... | 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...and advocating for appropriate levels of care. The UR Specialist works closely with clinical staff, admissions,… more
    BriteLife Recovery (09/02/25)
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  • Utilization Review Specialist

    MetroHealth (Cleveland, OH)
    ** Utilization Review Specialist - Utilization Management** **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** ... communicating information to internal and external customers of the Utilization Review and Care Management Department. Follows...accepted in lieu of a degree. Experience in a clinical or healthcare setting. Experience with and/or a strong… more
    MetroHealth (08/20/25)
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  • RN Utilization Review

    HonorHealth (AZ)
    …here -- because it does. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization ... urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization,… more
    HonorHealth (09/10/25)
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  • Physician Utilization Review

    Hackensack Meridian Health (Hackensack, NJ)
    The Senior Utilization Review Specialist collaborates with the healthcare team in the management and resolution of activities that assure the integrity of ... and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and transitions… more
    Hackensack Meridian Health (07/01/25)
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  • Utilization Review Case Management…

    Florida Health Care Plans, Inc. (Daytona Beach, FL)
    … Management Office Specialist provides clerical support to clinicians performing utilization review and case management for members hospitalized or receiving ... other levels of care. The UM office specialist will perform a variety of activities towards quality customer service being consistently delivered to members,… more
    Florida Health Care Plans, Inc. (09/07/25)
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  • Utilization Review Specialist

    Reno Behavioral Healthcare Hospital (Reno, NV)
    The UR Specialist reviews and monitors patients' utilization of health care services with the goal of maintaining high quality, cost-effective care. The duties ... include providing the medical and utilization expertise necessary to evaluate the appropriateness and efficiency...times. + Addresses care issues with the Director of Clinical Services and Chief Medical Officer/Medical Director as appropriate.… more
    Reno Behavioral Healthcare Hospital (07/26/25)
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