Talent.com
Texas Licensed Utilization Review Specialist

Texas Licensed Utilization Review Specialist

VirtualVocationsBronx, New York, United States
9 hours ago
Job type
  • Full-time
Job description

A company is looking for a Utilization Review Specialist to monitor and ensure the effective use of outpatient services.

Key Responsibilities

Establish and maintain methods for ensuring medical necessity and appropriateness of outpatient admissions

Perform concurrent reviews to justify extended patient stays and document findings

Compile monthly reports and statistics for the Utilization Review Committee

Required Qualifications

Graduation from an accredited university in Psychology, Sociology, or a similar behavioral health field

One year of utilization review experience preferred

Active CPR Certification

Create a job alert for this search

Utilization Review Specialist • Bronx, New York, United States

Related jobs
  • Promoted
Workers' Compensation Claims Examiner

Workers' Compensation Claims Examiner

VirtualVocationsYonkers, New York, United States
Full-time
A company is looking for a Claims Examiner, Medical Only.Key Responsibilities Investigate workers' compensation claims for medical care without lost wages Approve medical treatments, schedule ap...Show moreLast updated: 1 day ago
  • Promoted
  • New!
Pennsylvania Licensed Clinical Appeals Reviewer

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsAstoria, New York, United States
Full-time
A company is looking for a Clinical Appeals Reviewer.Key Responsibilities Process appeals while ensuring compliance with regulatory milestones Review medical records for documentation and billin...Show moreLast updated: 15 hours ago
  • Promoted
Pre-Certification Coordinator

Pre-Certification Coordinator

VirtualVocationsFlushing, New York, United States
Full-time
A company is looking for a Pre-Certification Coordinator I (Remote) - Surgery.Key Responsibilities Initiates and facilitates the pre-determination process with insurance companies Maintains dail...Show moreLast updated: 30+ days ago
  • Promoted
CA PERT SENIOR CASE REVIEWER

CA PERT SENIOR CASE REVIEWER

City of New YorkNew York, NY, US
Full-time +1
Applicants must be permanent in the Principal Administrative Associate Civil Service Title.The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with A...Show moreLast updated: 30+ days ago
  • Promoted
Intake & Registration Specialist

Intake & Registration Specialist

Columbia UniversityNew York, NY, United States
Full-time
Job Type : Officer of Administration.Salary Range : $65,800 - $72,000.The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departm...Show moreLast updated: 5 days ago
  • Promoted
ABA Intake Admin Assistant

ABA Intake Admin Assistant

VirtualVocationsNewark, New Jersey, United States
Full-time
A company is looking for an ABA Intake & Authorizations Admin Assistant - Spanish Speaking.Key Responsibilities Facilitate the client onboarding process and ensure accurate documentation and comm...Show moreLast updated: 1 day ago
  • Promoted
NCA PERT CASE REVIEWER

NCA PERT CASE REVIEWER

City of New YorkNew York, NY, US
Full-time +1
MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE The DSS Accountability Office (DSS-AO) is responsible for protecting the integrity of social services programs admini...Show moreLast updated: 30+ days ago
  • Promoted
MENTAL HEALTH CLERK

MENTAL HEALTH CLERK

The GEO GroupNewark, NJ, US
Full-time
Are you looking for a career you can feel good about? We hire only those that strive to do their best.By joining our family, you'll receive the honor and recognition that comes with working for...Show moreLast updated: 30+ days ago
Disability Services Assessor

Disability Services Assessor

Tap Growth aiManhattan, new york, US
Full-time
We're Hiring : IDD Assessor - Adult Services!.Individual Developmental Disabilities Assessor (Coordinated Assessment System (CAS) Assessor) to conduct assessments for adults with intellectual and de...Show moreLast updated: 1 day ago
  • Promoted
Enrollment Eligibility Representative

Enrollment Eligibility Representative

VirtualVocationsJackson Heights, New York, United States
Full-time
A company is looking for an Enrollment - Eligibility Representative.Key Responsibilities Research benefits, eligibility, and site of care for Medicare Part B members Communicate with doctor's of...Show moreLast updated: 1 day ago
  • Promoted
Intake Coordinator

Intake Coordinator

BrightSpring Health ServicesNew Hyde Park, NY, United States
Full-time
We are looking for an Intake Coordinator to join our Intake team as we grow to be one of the top home infusion providers in the country. The Intake Coordinator will report to the General Manager and...Show moreLast updated: 30+ days ago
  • Promoted
Healthcare Credentialing Coordinator

Healthcare Credentialing Coordinator

VirtualVocationsJackson Heights, New York, United States
Full-time
A company is looking for a Healthcare Credentialing Coordinator, part-time and remote.Key Responsibilities Manage the credentialing and re-credentialing process for healthcare providers, ensuring...Show moreLast updated: 1 day ago
  • Promoted
Prior Authorization Specialist

Prior Authorization Specialist

BrightSpring Health ServicesTotowa, NJ, United States
Full-time
Prior Authorization Specialist.This role will be responsible for activities relating to the proper initiation, clinical review, submission, and follow up of prior authorizations.This role requires ...Show moreLast updated: 30+ days ago
  • Promoted
Eligibility Specialist

Eligibility Specialist

VirtualVocationsElizabeth, New Jersey, United States
Full-time
A company is looking for an Eligibility Specialist to manage and maintain accurate eligibility and enrollment records for health and welfare benefit plans. Key Responsibilities : Process eligibilit...Show moreLast updated: 30+ days ago
  • Promoted
CA PERT SENIOR CASE REVIEWER

CA PERT SENIOR CASE REVIEWER

NYC JobsNew York, NY, US
Full-time +1
Principal Administrative Associate III.Applicants must be permanent in the Principal Administrative Associate Civil Service Title. The Office of Quality Assurance & Fiscal Integrity ensures the inte...Show moreLast updated: 30+ days ago
  • Promoted
  • New!
Surgical Authorization Specialist

Surgical Authorization Specialist

Progressive Spine and Orthopaedics LLCClifton, New Jersey, United States, 07011
Full-time
Quick Apply
JOB TITLE : Surgical Authorization Specialist SUMMARY : The Surgical Authorization Specialist at Progressive Spine & Orthopaedics is responsible for securing and managing surgical authorizations, wi...Show moreLast updated: 13 hours ago
  • Promoted
Medical Bill Navigator

Medical Bill Navigator

Zelis Healthcare, LLCMorristown, NJ, United States
Full-time
Zelis is modernizing the healthcare financial experience across payers, providers, and healthcare consumers.We serve more than 750 payers, including the top five national health plans, regional hea...Show moreLast updated: 21 days ago
  • Promoted
Utilization Management Coordinator

Utilization Management Coordinator

PROGYNYNew York, NY, United States
Full-time
Thank you for considering Progyny!.Progyny is looking for a Utilization Management Coordinator to support all utilization review cases. This coordinator will be directly responsible for reviewing an...Show moreLast updated: 7 days ago