• Utilization Review Physician

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

    Sutter Health (Sacramento, CA)
    …and case management within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation status. + Some awareness ... health care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under- utilization of resources, medical… more
    Sutter Health (08/28/25)
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  • Registered Nurse - Utilization

    Beth Israel Lahey Health (Boston, MA)
    …a difference in people's lives.** Position Summary: In conjunction with the admitting/attending physician , the Utilization Review RN assists in determining ... the level of care being billed. Conducts concurrent reviews as directed in the hospital's Utilization Review Plan and review of medical records to ensure… more
    Beth Israel Lahey Health (09/10/25)
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  • System VP Utilization Management

    CommonSpirit Health (Phoenix, AZ)
    …by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. + Physician Advisor Sub-specialty Certification ... This role will be an expert on matters regarding physician practice patterns, over and under- utilization of...by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred. **Required… more
    CommonSpirit Health (09/05/25)
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  • Medical Director - Behavioral Health, Aetna…

    CVS Health (Oklahoma City, OK)
    …psychiatrist. * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. * Child/Adolescent Board ... Medical Director (Behavioral Health), you will: * Provide leadership and day-to-day physician oversight for utilization management team, including the management… more
    CVS Health (08/27/25)
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  • Physician Advisor - UM MSQ

    BayCare Health System (Riverview, FL)
    …certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) + Preferred - Physician Advisor Sub-Specialty ... the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. + Develops expertise… more
    BayCare Health System (08/29/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply  UTILIZATION REVIEW NURSE ... see comprehensive information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team. Whether you're… more
    The County of Los Angeles (08/18/25)
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  • Utilization Review Nurse Supervisor…

    The County of Los Angeles (Los Angeles, CA)
    …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of physician more
    The County of Los Angeles (06/28/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …Group **Position Summary:** Reporting to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director ... our rapidly growing membership. The incumbent will have significant experience with utilization review , ideally experience with public programming, and excellent… more
    Commonwealth Care Alliance (09/05/25)
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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.Thisis a full-time role. *Purpose of this position: ... *Manages the design, development, implementation, and monitoring of utilization review functions. Oversees daily operations, which...actions to UR Committees, as appropriate * Partners with Physician Advisor to engage in second level review more
    Minnesota Visiting Nurse Agency (08/08/25)
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