Utilization Review jobs in Providence, RI

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Utilization Review Nurse
SALMON VNA and Hospice - Milford, MA 01757
Position is 32-40 hours working M-F. Responsibilities: * Review OASIS and ICD-10 coding Requirements: * Monday-Friday commitment * Current RN license *...
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Manager Behavioral Health (NaviCare) - Growing team and comp...
Fallon Health - 78 reviews - Worcester, MA
Ensures department team members work collaboratively with members of the Fallon Health Utilization Management Department....
Partial Hopitalization / Intensive Outpatient Program Therap...
Westborough Behavioral Healthcare Hospital - Westborough, MA 01581
Have a working knowledge of the utilization review process. Westborough Behavioral Healthcare Hospital*....
Easily apply
Admissions Liaison
Bane Care Management - Braintree, MA
Experience with case management, utilization review, insurance companies, and local hospitals preferred. Clinical Admissions Liaison-per diem*....
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Clinical Appeals, RN - Telecommute

UnitedHealth Group - 11,476 reviews - Taunton, MA 02780
Experience in Appeals and / or Utilization Management. Responsible for performing prior authorization review of services that require notification, using...

Prior Authorization, RN - Telecommute

UnitedHealth Group - 11,476 reviews - Taunton, MA 02780
Utilization Management experience. Perform / support clinical appeals (e.g., notes, previous reviews, obtain rationales) RN....

Grievance and Appeals Clinical Specialist

Neighborhood Health Plan of Rhode Island - 16 reviews - Smithfield, RI
Chart review experience. Research, review and facilitate documentation of Medicare/Medicaid benefits, policies and procedures as it relates to the department’s...

Computational Immunologist

EpiVax, Inc. - Providence, RI 02903 (Downtown area)
$62,000 - $80,000 a year
Maintains large-scale databases and prepares data for utilization by scientists; Communicates/presents data summaries, graphics, and statistical analysis...
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Per Diem Fitness Assistant

Wingate Healthcare - 30 reviews - Providence, RI 02906 (Blackstone area)
$20 - $25 an hour
Monitors and tracks resident utilization and program registrations/participation by establishing a tracking procedure....
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Administrative Coordinator - Community Outreach Coordinator

Lifespan - 143 reviews - Providence, RI 02903 (Downtown area)
Schedules staff priorities, assigns work to and reviews performance of subordinate clerical workers. Ability to develop utilization of and operate microcomputer...

Case Manager (NE) - SJH

CharterCARE Health Partners - 23 reviews - North Providence, RI
Utilizes professional nursing skills to assess patient and family needs for clinical appropriateness for the setting and establishes plans for effective...

Managing Director, Clinical Affairs

Blue Cross Blue Shield of Rhode Island - 32 reviews - Providence, RI 02903 (Downtown area)
Knowledge of managed benefits strategies, utilization review techniques, healthcare financing and delivery, and healthcare infrastructure design....

Carrier Relations Specialist

United Natural Foods Inc. - 623 reviews - Providence, RI
Complete analytics pertaining to service KPIs, market rates, utilization, and mode conversion. The Carrier Relations Specialist is the point of contact for the...


A. Autiello Construction Co Inc - Cranston, RI 02920
Review and ensure utilization of shop drawings and submittals. Manage distribution and utilization of plan revisions, RFIs and ASIs with onsite tradesmen....
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Registered Nurse (RN) - Case Management-Utilization Review
$78,000 a year
Candidates must have a minimum of 1 year experience in Case Management - Utilization Review and 2 years experience in an acute setting overall....
Utilization Review RN
Community Nurse Home Care - Fairhaven, MA 02719
Identify utilization trends through examination of relevant agency documentation. Complete/Assist in quarterly clinical record review as per the Medicare Home...
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