The Utilization Review Specialist monitors patient charts and records to evaluate care concurrent with the patients treatment. Conducts utilization reviews to determine if patients are receiving care appropriate to illness or condition. Being a Utilization Review Specialist collects and complies data as required and according to applicable policies and regulations. Reviews treatment plans and status of approvals from insurers. In addition, Utilization Review Specialist consults with physicians as needed. May require a bachelor's degree. Typically reports to a supervisor. Typically requires Reg ...istered Nurse(RN). Being a Utilization Review Specialist contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. Working as a Utilization Review Specialist typically requires 4 to 7 years of related experience.More Show Less
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THIS IS A REMOTE PRN (AS NEEDED) POSITION. Position Title. Utilization Review Specialist. . Department. Administration. . Reports To. Director, Utilization Review. . Supervises. NA. . Entry Level Qualifications. Health care degree‑Bachelors preferred. Two years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in office equipment i.e. typewriter, calculator, computer, copy machine an...
THIS IS A REMOTE PRN (AS NEEDED) POSITION. Position Title. Utilization Review Specialist. Department. Administration. Reports To. Director, Utilization Review. Supervises. NA. Entry Level Qualifications. Health care degree‑Bachelors preferred. Two years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in office equipment i.e. typewriter, calculator, computer, copy machine and fax ma...
THIS IS A REMOTE PRN (AS NEEDED) POSITION. Position Title. Utilization Review Specialist. . Department. Administration. . Reports To. Director, Utilization Review. . Supervises. NA. . Entry Level Qualifications. Health care degree‑Bachelors preferred. Two years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in office equipment i.e. typewriter, calculator, computer, copy machine an...
THIS IS A REMOTE PRN (AS NEEDED) POSITION. Position Title. Utilization Review Specialist. Department. Administration. Reports To. Director, Utilization Review. Supervises. NA. Entry Level Qualifications. Health care degree‑Bachelors preferred. Two years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in office equipment i.e. typewriter, calculator, computer, copy machine and fax ma...
THIS IS A REMOTE PRN (AS NEEDED) POSITION. Position Title. Utilization Review Specialist. Department. Administration. Reports To. Director, Utilization Review. Supervises. NA. Entry Level Qualifications. Health care degree‑Bachelors preferred. Two years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in office equipment i.e. typewriter, calculator, computer, copy machine and fax ma...
THIS IS A REMOTE PRN (AS NEEDED) POSITION. Position Title. Utilization Review Specialist. Department. Administration. Reports To. Director, Utilization Review. Supervises. NA. Entry Level Qualifications. Health care degree‑Bachelors preferred. Two years minimum experience in utilization review. Must possess good grammatical and communication skills. Must be skilled in office equipment i.e. typewriter, calculator, computer, copy machine and fax ma...
Overview. We are seeking a dedicated and detail-oriented Utilization Review Specialist to join our team at Yonder Behavioral Health. The Utilization Review Specialist plays a critical role in ensuring appropriate and medically necessary care for patients at Yonder Behavioral Health. This position is responsible for managing utilization review and authorizations for ASAM level 3.5 treatment, working closely with clinical teams to document medical ...
Job Details. Description. Join a purpose-driven team at Caron Treatment Centers, where for nearly 70 years, we’ve been helping people find a path to recovery from addiction and rebuild their lives. We offer real careers with real opportunities for growth, comprehensive training, and a commitment to work-life balance. Our benefits include generous paid time off, company-paid life and disability insurance, professional growth and development, tuiti...
Job Overview. We are seeking a dedicated and detail-oriented Utilization Review Specialist to join our healthcare team. In this role, you will be responsible for evaluating the appropriateness of patient care services and ensuring that they meet established guidelines and standards. The ideal candidate will possess a strong clinical background, excellent analytical skills, and a commitment to providing high-quality patient care. Duties. Conduct t...
REMOTE ROLE: SET SCHEDULE. MONDAY-FRIDAY 8AM-5PM PST, MUST BE ABLE TO WORK THIS SCHEDULE. The Role. As a. Utilization Review Specialist. you will be responsible for ensuring that healthcare services are medically necessary, efficiently provided, and appropriately utilized. This role involves reviewing patient medical records, assessing and evaluating requests for medical services, treatments, or procedures to determine their appropriateness, and ...
REMOTE ROLE: SET SCHEDULE. MONDAY-FRIDAY 8AM-5PM PST, MUST BE ABLE TO WORK THIS SCHEDULE. The Role. As a. Utilization Review Specialist. you will be responsible for ensuring that healthcare services are medically necessary, efficiently provided, and appropriately utilized. This role involves reviewing patient medical records, assessing and evaluating requests for medical services, treatments, or procedures to determine their appropriateness, and ...
ALTA IT Services is staffing a contract to hire opportunity for a Utilization Management Specialist to support a leading health insurance customer. The individual will perform prospective, concurrent and retrospective reviews for authorization, appropriateness of care determination and benefit coverage. Leveraging clinical expertise and critical thinking skills, the Utilization Review Specialist, will analyze clinical information, contracts, mand...
