Talent.com
Utilization Review Specialist
Utilization Review SpecialistVirtualVocations • Nashville, Tennessee, United States
Utilization Review Specialist

Utilization Review Specialist

VirtualVocations • Nashville, Tennessee, United States
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.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

serp_jobs.job_alerts.create_a_job

Utilization Review Specialist • Nashville, Tennessee, United States

Job_description.internal_linking.related_jobs
Regional Q&B Mgr, RME Continuous Improvement

Regional Q&B Mgr, RME Continuous Improvement

Amazon • Nashville, TN, US
serp_jobs.job_card.full_time
Amazon needs a results-driven Quality & Benchmark Manager to build and implement quality systems for Reliability & Maintenance Engineering (RME). This leader will guide field teams in creating effec...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Sterile Process Tech PRN - Cart Cart Operation Center

Sterile Process Tech PRN - Cart Cart Operation Center

Vanderbilt Health • Nashville, Tennessee, United States
serp_jobs.job_card.part_time
Discover Vanderbilt University Medical Center.Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Operations Specialist

Operations Specialist

AdaptHealth • Nashville, TN, US
serp_jobs.job_card.full_time
The Operations Specialist is responsible for supporting the Operations Team through multiple tasks required for the successful support of each region's individual needs. Essential Functions and Job ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Life & Annuity Contact Center Operations Manager

Life & Annuity Contact Center Operations Manager

DXC Technology • Nashville, TN, US
serp_jobs.job_card.full_time
Life & Annuity Contact Center Operations Manager.DXC Technology helps global companies run their mission critical systems and operations while modernizing IT, optimizing data architectures, and ens...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Access Specialist

Access Specialist

Vanderbilt University Medical Center • Nashville, TN, US
serp_jobs.job_card.full_time
Discover Vanderbilt University Medical Center.Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Life & Annuity Contact Center Operation Manager

Life & Annuity Contact Center Operation Manager

DXC Technology • Nashville, TN, US
serp_jobs.job_card.full_time
Life & Annuity Contact Center Operation Manager.DXC Technology helps global companies run their mission critical systems and operations while modernizing IT, optimizing data architectures, and ensu...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Associate Receiving Specialist (M-F, Dayshift)

Associate Receiving Specialist (M-F, Dayshift)

Vanderbilt University Medical Center • Nashville, TN, US
serp_jobs.job_card.full_time
Discover Vanderbilt University Medical Center.Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Continuous Improvement Specialist II

Continuous Improvement Specialist II

Thermo Fisher • Lebanon, TN, US
serp_jobs.job_card.full_time
When you're part of the team at Thermo Fisher Scientific, you'll do important work, like helping customers in finding cures for cancer, protecting the environment or making sure our food is safe.Yo...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Follow Up Specialist

Follow Up Specialist

Ovation Healthcare • Brentwood, TN, US
serp_jobs.job_card.full_time
Ovation Healthcare Follow-Up Specialist.Welcome to Ovation Healthcare!.At Ovation Healthcare, we've been making local healthcare better for more than 40 years. Our mission is to strengthen independe...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Director of Intake

Director of Intake

Pennant Group • Nashville, TN, US
serp_jobs.job_card.full_time
Are you a strategic, data-driven leader with a passion for optimizing healthcare operations? Do you thrive in fast-paced environments where precision, compliance, and collaboration are key? If so, ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Assistant Manager, New Patient Intake

Assistant Manager, New Patient Intake

Tennessee Oncology • Nashville, TN, US
serp_jobs.job_card.full_time
Assistant Manager Of New Patient Intake Team.Tennessee Oncology, one of the nation's largest, community-based cancer care specialists, is home to one of the leading clinical trial networks in the c...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Impact Evaluation Manager

Impact Evaluation Manager

Wounded Warrior Project • Nashville, TN, United States
serp_jobs.job_card.full_time
We know these are some of the things people look for in a job.If you're the kind of person who believes that honoring and empowering our nation's veterans is more than just a cause - that it's a ca...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Sr Director of Patient Access and Utilization Management

Sr Director of Patient Access and Utilization Management

Nashville General Hospital at Meharry • Nashville, TN, US
serp_jobs.job_card.full_time
Nashville General Hospital is hiring a Director of Patient Access for full-time Day!.The Director of Patient Access reports to the Chief Revenue Cycle and has oversight responsibility of all patien...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Associate Access Specialist

Associate Access Specialist

Vanderbilt University Medical Center • Nashville, TN, US
serp_jobs.job_card.full_time
Discover Vanderbilt University Medical Center.Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Prior Authorization Clinical Reviewer - RN, PT, OT or SLT, Mon-Fri 1pm-10pm CT - Remote

Prior Authorization Clinical Reviewer - RN, PT, OT or SLT, Mon-Fri 1pm-10pm CT - Remote

UnitedHealth Group • Brentwood, TN, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives.The work you do with our team will directly improve health outcomes by connect...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Central Sterile Process Tech 1- 3rd Shift- $5,000 Sign-On Bonus Available

Central Sterile Process Tech 1- 3rd Shift- $5,000 Sign-On Bonus Available

Vanderbilt Health • Nashville, Tennessee, United States
serp_jobs.job_card.full_time
Discover Vanderbilt University Medical Center.Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of individuals who ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Permanent Patient Access Manager Non-Clinical - Health and Information Management

Permanent Patient Access Manager Non-Clinical - Health and Information Management

Aya Healthcare • Nashville, TN, US
serp_jobs.job_card.permanent
Non-Clinical - Health And Information Management.Whether you have your eye set on a specific hospital or found a place you'd love to call home, we can help. As the nation's largest healthcare staffi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Intake Specialist

Intake Specialist

AdaptHealth • Columbia, TN, US
serp_jobs.job_card.full_time
At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives out of the hospital and in their homes. We are actively recruiting in ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Senior Manager of Patient Access

Senior Manager of Patient Access

R1 RCM • Nashville, TN, US
serp_jobs.job_card.full_time
Senior Manager Of Patient Access.R1 is the leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems and medical g...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Intake Services Manager

Intake Services Manager

Sevita • Nashville, TN, US
serp_jobs.job_card.full_time
The Sevita Family provides community-based services for individuals with intellectual and developmental disabilities.Here we believe every person has the right to live well, and everyone deserves t...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted