Virtual Utilization Review jobs

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Clearlink Partners LLC.
Trenton, NJ
Responsive employer
$80,000 - $90,000 a year
Health insurance utilization review:. Perform utilization management, utilization review or concurrent review (inpatient care management)....
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Clearlink Partners LLC.
San Diego, CA
Responsive employer
$70,000 - $90,000 a year
Health insurance utilization review:. Utilization Management Nurse- Remote *. Performing concurrent reviews of inpatient and inpatient sub-acute claims as well...
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Orlando, FL 32885 (Central Business District area)
Hands-on experience in utilization and coverage review in a health plan with commercial membership. O Communicate and collaborate with other departments such as...
Tampa, FL 33646 (Downtown area)
5+ years hands-on experience in utilization and coverage review in a health plan with Commercial membership. Clinical Coverage Review Medical Director....
Physicians Medical Group /Excel MSO
San Jose, CA 95131 (North Valley area)
$80,000 - $98,000 a year
Our nurses review member hospitalization authorization requests to ensure effective and appropriate utilization of benefits and healthcare services....
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Dallas, TX 75201 (City Center District area)
The Utilization Review Nurse provides ongoing communication with health plan utilization departments regarding medical necessity for prospective, concurrent,...
ProgenyHealth
Plymouth Meeting, PA 19462 +1 location
Utilization Management / Clinical Care Nurses coordinate overall member care, from pre-admission, continued stay (concurrent review) and any outpatient services...
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VIRTUAL UTILIZATION REVIEW. The Virtual Utilization Review CM facilitates the improvement of overall quality and completeness of medical record documentation....
The Utilization Review Specialist will determine the appropriate cases for review, utilizing client specific guidelines....
McBee
Remote
Part-time Utilization Review Nurse. Utilization Review experience and knowledge of InterQual and/or Milliman criteria is required....
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Both perform some functions of Personal Health Management and Utilization Management. Excellent verbal communication skills with the ability to communicate with...
Follows Utilization Management and URAC/NCQA standards. Excellent knowledge of Utilization Management and URAC/NCQA standards....
Maintain ongoing communication with supervisor regarding issues/nuances that arise during review processes; The Coding Abstractor is responsible for conducting...
Oversight of readmission review among the Utilization Management department. A Day in the Life of a Utilization Management Readmission Review Nurse:....
Work at Home
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. The UM Administration Coordinator 2 contributes to...
Work at Home
Experience with Utilization Review and/or Prior Authorization, preferably within a managed care organization. The UM Administration Coordinator 2 contributes to...
Inovalon, Inc.
Atlanta, GA
Maintain ongoing communication with supervisor regarding issues/nuances that arise during review processes; The Coding Abstractor is responsible for conducting...
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Clearlink Partners LLC.
San Antonio, TX
Responsive employer
$75,000 - $85,000 a year
Utilization Review Nurse- Remote *. Our Utilization Review Nurses are responsible for ensuring proper utilization of health services by assessing the member’s...
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