Utilization Review SpecialistVirtualVocations • Lawrenceville, Georgia, United States
Utilization Review Specialist
VirtualVocations • Lawrenceville, Georgia, United States
3 days ago
Job type
- Full-time
Job description
A company is looking for a Utilization Review Specialist.
Key Responsibilities
Review and process Independent Review (IR) requests for potential conflicts of interest
Request and organize additional medical documentation for Physician Advisors
Ensure all work meets Client, State, Federal, and URAC compliance standards
Qualifications
High school diploma or equivalent required
Minimum of 1 year in a healthcare-related setting required
Knowledge of HIPAA rules and regulations required
Prior experience in utilization review, medical management, or insurance preferred
Create a job alert for this search
Utilization Review Specialist • Lawrenceville, Georgia, United States
Related jobs A company is looking for an Intake Specialist.Key Responsibilities Accurately enter referrals and communicate with referral sources to ensure documentation is completed Review medical records fo...Show more A company is looking for a Utilization Rev Appeals Specialist.Key Responsibilities Review patient medical records to determine reasons for denials and required appeals Collaborate with various d...Show more 
DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.
As a Dasher, you’ll stay busy with a var...Show more DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.
As a Dasher, you’ll stay busy with a var...Show more A company is looking for a Utilization Management RN.Key Responsibilities Monitor admissions and perform medical necessity reviews for initial and continued stays Collaborate with the multidisci...Show more A company is looking for a Utilization Review Nurse.Key Responsibilities Perform prospective, concurrent, and retrospective utilization reviews using evidence-based guidelines Evaluate severity ...Show more A company is looking for a Manager, Patient Access to lead and grow their Patient Care Representatives.Key Responsibilities Lead, coach, and develop a high-performing Patient Access team to deliv...Show more 
Children's is one of the nation's leading children's hospitals.No matter the role, every member of our team is an essential part of our mission to make kids better today and healthier tomorrow.We'r...Show more
Manager, Utilization Management.The Manager of Utilization Management plays a pivotal role in ensuring that hospital resources are used efficiently, appropriately, and in alignment with clinical be...Show more DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.
As a Dasher, you’ll stay busy with a var...Show more A company is looking for a Utilization Management Assistant to join their healthcare team.Key Responsibilities Answer first level calls in Utilization Review for HealthCheck360 participants Eval...Show more A company is looking for a Utilization Management Nurse to review and monitor healthcare service utilization for members.
Key Responsibilities Conducts concurrent and retrospective reviews of faci...Show more 
The Director of Utilization Management (UM) and Clinical Documentation Improvement (CDI) is responsible for leading and managing the Utilization Management (UM) and Clinical Documentation Improveme...Show more A company is looking for an Outcomes Specialist.Key Responsibilities Identify and implement operational performance improvement projects aligned with organizational goals Collaborate with variou...Show more A company is looking for a Utilization Management Nurse RN - Remote.Key Responsibilities Validates authorization for procedures and manages concurrent cases to resolution Conducts medical necess...Show more A company is looking for a Utilization Review Specialist.Key Responsibilities Review and process Independent Review (IR) requests for potential conflicts of interest Request and organize additio...Show more DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.
As a Dasher, you’ll stay busy with a var...Show more A company is looking for a Utilization Management Intake Coordinator.Key Responsibilities Handles incoming authorization requests efficiently and accurately Determines authorization requirements...Show more A company is looking for a Utilization Management Supervisor (Remote within Arkansas).Key Responsibilities Manage and oversee Utilization Management activities Ensure clinical programs meet high...Show more DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.
As a Dasher, you’ll stay busy with a var...Show more
Intake Specialist
VirtualVocations • Norcross, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Utilization Review Appeals Specialist
VirtualVocations • Norcross, Georgia, United States
Full-time
Last updated: 4 days ago • Promoted
Restaurant Delivery - Sign Up in Minutes
DoorDash • Peachtree Corners, GA, United States
Full-time +1
Last updated: 30+ days ago • Promoted
Delivery Driver - Sign Up in Minutes
DoorDash • Auburn, GA, United States
Full-time +1
Last updated: 30+ days ago • Promoted
Florida Licensed Utilization Management RN
VirtualVocations • Decatur, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Licensed Utilization Review Nurse
VirtualVocations • Norcross, Georgia, United States
Full-time
Last updated: 4 days ago • Promoted
Patient Access Manager
VirtualVocations • Lawrenceville, Georgia, United States
Full-time
Last updated: 3 days ago • Promoted
Manager, Utilization Review (RN)
Children's Healthcare of Atlanta • Atlanta, GA, US
Full-time
Last updated: 30+ days ago • Promoted
Manager, Utilization Management
Piedmont Healthcare • Atlanta, GA, US
Full-time
Last updated: 30+ days ago • Promoted
Dashers - Sign Up and Start Earning
DoorDash • Social Circle, GA, United States
Full-time +1
Last updated: 30+ days ago • Promoted
Utilization Management Assistant
VirtualVocations • Decatur, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Utilization Management Nurse
VirtualVocations • Alpharetta, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Utilization Management and Clinical Documentation Improvement Director - RN Required
Northeast Georgia Health System • Gainesville, GA, US
Full-time
Last updated: 30+ days ago • Promoted
RN Outcomes Specialist
VirtualVocations • Norcross, Georgia, United States
Full-time
Last updated: 4 days ago • Promoted
Maine Licensed Utilization Management Nurse
VirtualVocations • Decatur, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Utilization Review Specialist
VirtualVocations • Atlanta, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Restaurant Delivery - Flexible Schedule
DoorDash • Newborn, GA, United States
Full-time +1
Last updated: 30+ days ago • Promoted
Utilization Management Coordinator
VirtualVocations • Alpharetta, Georgia, United States
Full-time
Last updated: 30+ days ago • Promoted
Arkansas Licensed Utilization Supervisor
VirtualVocations • Atlanta, Georgia, United States
Full-time
Last updated: 2 days ago • Promoted
Restaurant Delivery - Sign Up and Start Earning
DoorDash • Braselton, GA, United States
Full-time +1
Last updated: 30+ days ago • Promoted