• PRN Clinical Utilization Review…

    Community Health Systems (Franklin, TN)
    **Job Summary** The Remote PRN Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of ... and collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital … more
    Community Health Systems (12/03/25)
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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 ... population and Hackensack UMC. These include but are not limited to utilization review , hospital reimbursement, clinical compliance, case management, and… more
    Hackensack Meridian Health (11/12/25)
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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 ... Specialist | Insurance Specialist | UR Specialist | Revenue Cycle Utilization Review Specialist | ABA Utilization Review Specialist |… more
    Spectrum Billing Solutions (10/30/25)
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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 receiving substance use disorder (SUD)… more
    BriteLife Recovery (01/05/26)
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  • Utilization Review Specialist

    TEKsystems (Los Angeles, 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. ... provider and member claims for accuracy and compliance + Review and process claims in accordance with UM guidelines...RN license (California) + 2+ years of experience in Utilization Management (UM) + Hands-on experience with HMO/Medicare claims,… more
    TEKsystems (12/31/25)
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  • Utilization Review Specialist

    WestCare Foundation (Henderson, NV)
    …LPN or RN and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric ... or substance use disorder Experience and Competencies: + Proven experience in conceptualizing a case and creating a clinical impression to present to all involved and approved parties, including managed care representatives + Knowledge of CPT, ICD 9 & ICD 10… more
    WestCare Foundation (11/13/25)
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  • Utilization Review RN

    BayCare Health System (Tampa, FL)
    …a foundation of trust, dignity, respect, responsibility and clinical excellence. **The Utilization Review Specialist Senior/RN responsibilities include:** + ... + Preferred Masters in Nursing or Business **Experience:** + Required 2 years in Utilization Review or + Required 2 years in Case Management or + Required 3… more
    BayCare Health System (01/09/26)
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  • Utilization Review Coordinator

    Community Health Systems (Franklin, TN)
    …to secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of utilization review processes, including denials and… more
    Community Health Systems (11/22/25)
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  • Support Specialist - Utilization…

    Henry Ford Health System (Troy, MI)
    The support specialist is a support role crucial to the centralized Utilization Review team for time sensitive authorization tracking and resolution process. ... Epic preferred. Additional Information + Organization: Corporate Services + Department: Central Utilization Mgt + Shift: Day Job + Union Code: Not Applicable… more
    Henry Ford Health System (12/23/25)
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  • Healthcare Clinical Documentation…

    Deloitte (Los Angeles, CA)
    …clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...financial concerns and other business controversy. A Clinical Documentation Specialist (CDS) works to ensure accuracy and completeness of… more
    Deloitte (11/21/25)
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