Utilization - 2,748+ job offers

*Work Arrangement:** Remote *Requisition Number:** 267546 *Regular or Temporary:** Regular *Location:**Raleigh, NC, US, 27710 *Personnel Area:** DUKE RALEIGH CAMPUS *Date:** Mar 12, 2026 At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their love

Overview ​PURPOSE STATEMENT: ​Provide administrative support to the Utilization department. Responsibilities ESSENTIAL FUNCTIONS: ​Perform pre-certification and negotiate continued stay with third party payers. ​Gather data to support case management activities, including presentation of gathered da

Overview ​PURPOSE STATEMENT: ​Proactively monitor utilization of services for patients to optimize reimbursement for the facility. Responsibilities ​ESSENTIAL FUNCTIONS: ​Act as liaison between managed care organizations and the facility professional clinical staff. ​Conduct reviews, in accordance w

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. *About Duke Raleigh Hospital, A Campus of Duke University Hos

About Claratel Behavioral Health Claratel Behavioral Health is an innovative, community-based behavioral health and developmental disabilities services organization offering a full range of mental health, developmental disabilities, and substance use disorder services to underserved individuals. As

Our Promise To You Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually,

Responsibilities Utilization Management Coordinator PRN- As Needed Monday - Friday (Not Remote) Quail Run Behavioral Health Hospital in Phoenix is seeking a dynamic and talented UM Coordinator to join our team of compassionate, dedicated professionals in our utilization review department Benefits in

Description Summary: The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective

Description Job Summary The UR Coordinator’s primary responsibility is managing, reviewing, and monitoring utilization of patient resources and obtaining payor authorization as required for all provided services. The UR Coordinator will function as liaison between payor source(s), the finance office

About The Role BHPS provides Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member’s benefit coverage while working remotely. Primary Respon

*GENERAL SUMMARY:** Conducts day-to-day activities for the clinical, financial and utilization coordination of the patient’s hospital experience. Proactively consults with the interdisciplinary team which includes, but is not limited to, hospital patient care staff, physicians, patient support and f

Our Promise To You: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually

*Purpose Statement** Proactively monitor utilization of services for patients to optimize reimbursement for the facility. *Essential Functions** Act as liaison between managed care organizations and the facility professional clinical staff. Conduct reviews, in accordance with certification requireme

Your future role at a glance Department: Case Management Schedule: Full time, Days Hospital: Ascension St Thomas Location: Remote Salary: $16.88 - $25.13 Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience

Your future role at a glance Department: Case Management Schedule: Full Time, Days Hospital: Ascension St Thomas Location: Remote Salary: $16.88 - $25.13 Life at Ascension: Where purpose meets opportunity Ascension is a leading nonprofit Catholic health system with a culture and associate experience

*General Summary** Conducts day-to-day activities for the clinical, financial and utilization coordination of the patient’s hospital experience. Proactively consults with the interdisciplinary team which includes, but is not limited to, hospital patient care staff, physicians, patient support and fa

Imagine a piloted air taxi that takes off vertically, then quietly carries you and your fellow passengers over the congested city streets below, enabling you to spend more time with the people and places that matter most. At Joby, we've been working to make that dream a reality since 2009 and we're

Guidelight Health is a cutting-edge behavioral healthcare company dedicated to transforming lives through high-quality PHP (Partial Hospitalization Program) and IOP (Intensive Outpatient Program) services. As a newly launched organization, we are on a mission to redefine the behavioral health indust

Overview ​PURPOSE STATEMENT: North Tampa Behavioral Health is seeking a Utilization Review Specialist to support our clinical and reimbursement processes. This role works closely with the treatment team and insurance providers to ensure medical necessity, obtain authorizations, and facilitate contin

The Utilization Review Support Specialist completes and documents in Cone Healthlink (CHL/EPIC) payor communication to include notification of beneficiary admission per payor requirements and timelines, authorization status and contact information for clinical follow-up. Essential Job Function Revie