Utilization Review jobs in Providence, RI

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Utilization and Appeal Specialist
Beth Israel Deaconess Hospital-Milton - Milton, MA
Reviews and determines appropriate strategy in response to denials of reimbursement. Acts as liaison with Mass Pro, Centers for Medicare and Medicaid Services...
Director Case Management Utilization Review
Clinical Management Consultants - Providence, RI
$92,439 - $131,821 a year
Director Case Management Utilization Review Job in Providence RI. Nurse Director Case Management, Nurse Director Care Management, Nurse Director Utilization...
Registered Nurse - Certified Medicare OASIS Coder
Care Resource - East Providence, RI
Review OASIS, assessment documents and Medical coding at individual branch locations to ensure consistent application and follow through....
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Human Resources - Compensation Specialty

United Natural Foods Inc. - 299 reviews - Providence, RI
Makes recommendations on system enhancements and utilization by leveraging functionality. Provide data for review of the annual salary budget, eligibility...

Health System Specialist

Department of Veterans Affairs - 2,121 reviews - Providence, RI
Quality Management consists of the programs of Patient Safety, Risk Management, Regulatory Readiness, System Redesign, Patient Experience, utilization...

Case Manager - Payor Liaison

Lifespan - 84 reviews - Providence, RI 02903 (Downtown area)
Utilization review experienced required. Under general direction of department manager, functions as affiliate-specific liaison for utilization review with...


The State of Rhode Island - Cranston, RI 02920
$57,041 - $64,513 a year
To review agency staffing needs and employees' skills and abilities, and to recommend optimum utilization of available employee resources....

Nurse Reviewer

Blue Cross Blue Shield of Rhode Island - 3,218 reviews - Providence, RI
Certification, Certified Professional Utilization Review certification. Review function, including pre-authorization, concurrent review, screening for....

Behavioral Health Clinician

CharterCARE Health Partners - Providence, RI
Utilization review and inpatient behavioral health experience preferred. Also assists with case reviews with insurers, admissions and discharge planning....

RN, Care Manager

Memorial Hospital of Rhode Island - 17 reviews - Pawtucket, RI
Recent knowledge of case management, utilization review, quality assurance and third party payer regulations is deserable, but will train....


The State of Rhode Island - Cranston, RI 02920
$79,562 - $90,239 a year
Considerable employment in a professional position performing review and analysis of policies and programs in a governmental, public affairs or business context...

Social Service Clinician

Butler Hospital - 27 reviews - Providence, RI 02906 (Blackstone area)
Responsibilities to include performing psychosocial assessments, utilization review, discharge planning and other case management type duties on our inpatient...

Delegate Oversight Analyst

Blue Cross Blue Shield of Rhode Island - 3,218 reviews - Providence, RI
Knowledge of Utilization Review Accreditation Commission requirements and guidelines. Knowledge of CMS and RI state laws governing utilization review....
Clinical Supervisor, Worcester
You Inc - 14 reviews - Southbridge, MA
Assistwith program management including referrals, intake, billing, and networking aswell as day-to-day program operations Carrya supervisory caseload of no...
Center Nurse Executive (DON)
Completes performance reviews and determines compensation and promotions based on the accomplishment of established standards that promote adherence to...
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Company with Utilization Review jobs
Beth Israel Deaconess Hospital –Milton, community med/surg hospital, Milton, Mass. GI, ED, cardiology, surgery, ortho, urology specialties.