Talent.com
Utilization Review Specialist
Utilization Review SpecialistVirtualVocations • Davie, Florida, United States
Utilization Review Specialist

Utilization Review Specialist

VirtualVocations • Davie, Florida, 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 • Davie, Florida, United States

Job_description.internal_linking.related_jobs
Utilization Review Coordinator

Utilization Review Coordinator

Arista Recovery • Miami, FL, US
serp_jobs.job_card.full_time
The primary responsibility of this position is to implement the organization’s Utilization Review (UR) process so as to ensure appropriate usage of available resources and to optimize reimbur...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Case Manager, Utilization Review-Case Mgmt-Pool-Days-BHC #23403

Case Manager, Utilization Review-Case Mgmt-Pool-Days-BHC #23403

Broward Health • Fort Lauderdale, FL, US
serp_jobs.job_card.full_time
Summary : Performs and monitors integrated, concurrent utilization review and case referrals on patients, consistent with the approved Utilization Review Plans. Works with medical and professional st...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Intake Specialist

Intake Specialist

1-800-No-Fault • Miami, FL, US
serp_jobs.job_card.full_time
The No Fault Group is seeking motivated and dynamic Intake Specialists to join our incredible team! Our mission is to provide comprehensive support by overseeing cases from start to finish, ensurin...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Associate Director Radiopharmaceutical Clinical Applications - Southeast (NC, GA, FL, SC, AL)

Associate Director Radiopharmaceutical Clinical Applications - Southeast (NC, GA, FL, SC, AL)

Lantheus • Miami Beach, FL, United States
serp_jobs.job_card.full_time
Lantheus is headquartered in Bedford, Massachusetts with offices in Canada, and Sweden.For more than 60 years, Lantheus has been instrumental in pioneering the field of medical imaging and has help...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Utilization Management Nurse

Utilization Management Nurse

Solis Health Plans • Miami, FL, US
serp_jobs.job_card.full_time
Solis Health Plans is a new kind of Medicare Advantage Company.We provide solutions that are more transparent, connected and effective for both our members and providers. Solis was born out of a des...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Director of Compensation | UF Health System - Remote Opportunity

Director of Compensation | UF Health System - Remote Opportunity

UF Health • Hollywood, FL, US
serp_jobs.filters.remote
serp_jobs.job_card.full_time
Join Our Team at UF Health, Human Resources.UF Health Human Resources is seeking a thoughtful and experienced.This is a remote position, open to candidates living in Florida, and offers a unique op...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
RCM OPEX Specialist

RCM OPEX Specialist

Femwell Group Health • Miami, FL, United States
serp_jobs.job_card.full_time
The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant wit...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Manager

Manager

American Multi-Cinema, Inc. • Hialeah, FL, United States
serp_jobs.job_card.full_time
As a Manager, you'll lead operations and people with purpose-supporting AMC's Mission while bringing our Values to life.You'll drive results through coaching, communication, and ownership, and help...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Sr. Access & Reimbursement Manager - (Miami FL)

Sr. Access & Reimbursement Manager - (Miami FL)

Eisai • Miami, FL, 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_30 • serp_jobs.job_card.promoted
RCM OPEX Specialist (Miami)

RCM OPEX Specialist (Miami)

Femwell Group Health • Miami, FL, US
serp_jobs.job_card.part_time
The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant wit...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Experience Operations Specialist

Experience Operations Specialist

LMS • Fort Lauderdale, FL, US
serp_jobs.job_card.full_time
LMS / GEM, a fast-growing firm with a dynamic, independent, entrepreneurial culture, is actively recruiting team members to support a Global Cruise Operator. Our organization is a tangible category di...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Behavioral Health Utilization Review Nurse

Behavioral Health Utilization Review Nurse

Actalent • Fort Lauderdale, FL, US
serp_jobs.job_card.full_time
Actalent is Hiring a Behavioral Health Utilization Review Nurse.We are seeking a dedicated Utilization Management Nurse (UMN) who will work collaboratively with an interdisciplinary team under the ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Restaurant Delivery - Sign Up in Minutes

Restaurant Delivery - Sign Up in Minutes

DoorDash • Hialeah, FL, United States
serp_jobs.job_card.full_time +1
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 variety o...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Operational Oversight & Control Associate - Equities & Fixed Income Operations

Operational Oversight & Control Associate - Equities & Fixed Income Operations

Santander Holdings USA Inc • Miami, FL, US
serp_jobs.job_card.full_time
Operational Oversight & Control Associate - Equities & Fixed Income Operations.Country : United States of America.Santander is a global leader and innovator in the financial services industr...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Utilization Review Manager

Utilization Review Manager

Mount Sinai Medical Center • Miami Beach, FL, United States
serp_jobs.job_card.full_time
Care Management Business Operations Manager.As Mount Sinai grows, so does our legacy in high-quality health care.Since 1949, Mount Sinai Medical Center has remained committed to providing access to...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Utilization Review Manager (Miami Beach)

Utilization Review Manager (Miami Beach)

Mount Sinai Medical Center • Miami Beach, FL, US
serp_jobs.job_card.part_time
Care Management Business Operations Manager.As Mount Sinai grows, so does our legacy in high-quality health care.Since 1949, Mount Sinai Medical Center has remained committed to providing access to...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Director of Compensation | UF Health System – Remote Opportunity

Director of Compensation | UF Health System – Remote Opportunity

UF Health • Hollywood, FL, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
Join Our Team at UF Health, Human Resources.UF Health Human Resources is seeking a thoughtful and experienced.This is a remote position, open to candidates living in Florida, and offers a unique op...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Continuous Improvement Specialist

Continuous Improvement Specialist

Mini-Circuits • Hialeah, FL, US
serp_jobs.job_card.full_time
Continuous Improvement Specialist.The Continuous Improvement Specialist plays a key role in implementing operational excellence practices and maximizing efficiency within the organization.This posi...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Utility Contract Specialist

Utility Contract Specialist

GAI Consultants Inc. • Fort Lauderdale, FL, United States
serp_jobs.job_card.full_time
Eland Engineering, a GAI Consultants company, is looking for a Utility Contract Specialist to work out of our Ft.Lauderdale, FL office location. The successful candidate will have had 2-4 years of r...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Regional Operations Manager - Miami, FL

Regional Operations Manager - Miami, FL

Matheson Tri-Gas • Miami Beach, FL, United States
serp_jobs.job_card.full_time
JOB TITLE - REGIONAL OPERATIONS MANAGER.This focus of this position is to support and enforce all safety, governmental, and Company procedures while meeting operational goals.This position will pro...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted