Talent.com
Utilization Review Specialist
Utilization Review SpecialistVirtualVocations • Akron, Ohio, United States
Utilization Review Specialist

Utilization Review Specialist

VirtualVocations • Akron, Ohio, United States
job_description.job_card.1_day_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 • Akron, Ohio, United States

Job_description.internal_linking.related_jobs
Recertification Specialist

Recertification Specialist

Akron Metropolitan Housing Authority • Akron, OH, United States
serp_jobs.job_card.temporary
MsoNormalTable {mso-style-name : "Table Normal"; mso-tstyle-rowband-size : 0; mso-tstyle-colband-size : 0; mso-style-noshow : yes. mso-style-priority : 99; mso-style-parent : ""; mso-paddi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Senior Manager, Access & Reimbursement Manager - Cleveland, Columbus, Akron, OH - Field Based

Senior Manager, Access & Reimbursement Manager - Cleveland, Columbus, Akron, OH - Field Based

Eisai • Cleveland, OH, United States
serp_jobs.job_card.full_time
At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission.We're a growing pharm...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
New Grad RN Resident - Progressive Care Unit (PCU)

New Grad RN Resident - Progressive Care Unit (PCU)

Cleveland Clinic • Medina, OH, US
serp_jobs.job_card.full_time
Join Cleveland Clinic Medina Hospital and experience world-class healthcare at its best.As a proud recipient of the Vizient, Inc. Birnbaum, MD, Quality Leadership Award, Medina Hospital is known for...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN Manager, Occupational Heatlh

RN Manager, Occupational Heatlh

Western Reserve Hospital • Cuyahoga Falls, OH, US
serp_jobs.job_card.full_time
Western Reserve Hospital is Northeast Ohio's first physician-owned, for-profit, full-service hospital.The hospital is a collaboration of over 200 physicians, including primary care doctors, surgeon...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN Transitional Care Coordinator-St. John Medical Center

RN Transitional Care Coordinator-St. John Medical Center

University Hospitals • Westlake, OH, US
serp_jobs.job_card.full_time
Ensures appropriate next site of care for patient using evidence-based decision support tools.The Transitional Care Coordinator (TCC) collaborates with all members of a patient's care team, inc...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN - Clinical Decision Unit

RN - Clinical Decision Unit

Cleveland Clinic • Canton, OH, US
serp_jobs.job_card.full_time +1
This position is eligible for a shift differential of $5 / hour.Join Cleveland Clinic’s Mercy Hospital where research and surgery are advanced, technology is leading-edge, patient care is world...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Intake Specialist

Intake Specialist

Kisling, Nestico & Redick • Fairlawn, OH, US
serp_jobs.job_card.full_time
The Intake Specialist is responsible for the day-to-day operations of the Intake Department.This person reports directly to the Intake Manager and acts under his or her direction.Answer phones in h...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN - Coronary Care Unit

RN - Coronary Care Unit

Cleveland Clinic • Canton, OH, US
serp_jobs.job_card.full_time +1
This position is eligible for a shift differential of $5 / hour.Join Cleveland Clinic’s Mercy Hospital where research and surgery are advanced, technology is leading-edge, patient care is world...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN - Epilepsy Monitoring Unit

RN - Epilepsy Monitoring Unit

Cleveland Clinic • Akron, OH, US
serp_jobs.job_card.full_time
ONA Bidding Period : 07 / 15 / 25 to 07 / 19 / 25.Join us at Cleveland Clinic Akron General Hospital where we have been providing world-class care to our community for over 100 years.Here, we strive for pat...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN - Float

RN - Float

Cleveland Clinic • Canton, OH, US
serp_jobs.job_card.full_time +1
This position is eligible for a shift differential of $5 / hour.Join Cleveland Clinic Mercy Hospital and experience world-class healthcare at its best. Officially becoming a full member of the Clevela...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RN - Rehabilitation Unit

RN - Rehabilitation Unit

Cleveland Clinic • Canton, OH, US
serp_jobs.job_card.full_time +1
This position is eligible for a shift differential of $5 / hour.Join Cleveland Clinic Mercy Hospital and experience world-class healthcare at its best. Mercy Hospital provides state-of-the-art healthc...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Safety Quality Patient Experience Specialist II

Safety Quality Patient Experience Specialist II

Cleveland Clinic • Cleveland, OH, US
serp_jobs.job_card.full_time
Safety Quality Patient Experience Specialist II.Join Cleveland Clinic Hillcrest Hospital and experience world-class healthcare at its best. Hillcrest Hospital provides state-of-the-art healthcare to...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
RN - OB

RN - OB

Cleveland Clinic • Westlake, OH, US
serp_jobs.job_card.full_time
ONA Bidding Period : 10 / 17-10 / 22.Join Cleveland Clinic Union Hospital and experience world-class healthcare at its best. Located in Dover, Ohio, Union Hospital is an award-winning not-for-profit comm...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Patient Access Specialist

Patient Access Specialist

LHH • Cuyahoga Falls, OH, US
serp_jobs.job_card.full_time
Title : Patient Access Specialist.Employment type : Contract (13 weeks).Location : Float between Cuyahoga Falls & Kent, OH. Hours : M-F, standard business hours.Register patients accurately in Cerne...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Director of Quality Management - Inpatient Rehab

Director of Quality Management - Inpatient Rehab

Select Medical • Cleveland, OH, US
serp_jobs.job_card.full_time
Director of Quality Management.Cleveland Clinic Rehabilitation Hospital - Fairhill offers you the chance to make a difference from day one! Opening in October, the hospital provides a supportive en...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Medical Review Specialist

Medical Review Specialist

Christian Healthcare Ministries • Barberton, OH, US
serp_jobs.job_card.full_time
The Medical Review Team at Christian Healthcare Ministries (CHM) is entrusted with representing the organization's vision and mission, particularly regarding the determination of pre-existing condi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Utilization Review Nurse (RN)- FT Nights

Utilization Review Nurse (RN)- FT Nights

Bluestone Child & Adolescent Psychiatric Hospital • Brecksville, OH, US
serp_jobs.job_card.full_time
Utilization Review Registered Nurse- FT Nights, 5-8 hour shifts- Sunday through Thursday.Immediately respond to all Bluestone Intak email, faxes and phone calls. Review all referrals for clinical ap...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Unit Operations Specialist III, Adjunct Services

Unit Operations Specialist III, Adjunct Services

Tri-C • Cleveland, OH, US
serp_jobs.job_card.full_time
Unit Operations Specialist III, Adjunct Services.Provides functional supervision, coordinates activities of support personnel and performs a variety of complex / diversified tasks related to unit ope...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
New Grad RN Resident - Epilepsy Monitoring Unit

New Grad RN Resident - Epilepsy Monitoring Unit

Cleveland Clinic • Akron, OH, US
serp_jobs.job_card.full_time
ONA Bidding Period : 07 / 15 / 25 to 07 / 19 / 25.Join us at Cleveland Clinic Akron General Hospital where we have been providing world-class care to our community for over 100 years.Here, we strive for pat...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Home Health Aide

Home Health Aide

Interim HealthCare • Sugarcreek, OH, US
serp_jobs.job_card.temporary
As a Home Health Aide.F;you will be called to care when you’re needed most.As part of Interim HealthCare, you’ll support a full range of patient services to bring comfort ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted