Top 39 utilization review Jobs in milwaukee wi

RN DENIALS MANAGEMENT HOURLY
Froedtert Health —Milwaukee, WI
- $36.38 - $56.39 an hour
- Part-time
- Nursing
- RN License
- 5 years
- Continuing education credits
- Disability insurance
Visit RN - Weekend Program - ProHealth Home Care and Home Hospice- Benefits Eligible
ProHealth Care —Hartland, WI
- 12 hour shift
- CPR Certification
- Nursing
- Clean driving record
Supervisor, Healthcare Services (Brown, Fon du Lac, Manitowoc, & Winnebago Counties, WI)
Molina Healthcare —Milwaukee, WI
- $66,456 - $129,590 a year
- Full-time
- LMFT
- LVN
- RN License
- Health insurance
10d
VP, Healthcare Services (Wisconsin)
Molina Healthcare —Wauwatosa, WI
- $161,914.25 - $315,733.00 a year
- Full-time
- Remote
- LMFT
- Nursing
- 7 years
- Health insurance
BH Case Manager: Weekend Program
Advocate Aurora Health —Wauwatosa, WI
- $33.05 - $49.60 an hour
- Part-time
- Nursing
- RN License
- BLS Certification
DIR UTIL REVIEW & DENIALS MGMT ENTERPRISE QUALITY FROEDTERT HOSPITAL REMOTE
Froedtert Health —Milwaukee, WI
- $53.51 - $90.97 an hour
- Full-time
- Nursing
- RN License
- Customer service
- Continuing education credits
- Disability insurance
Human Resources Generalist
DERSE INC —Milwaukee, WI
- 5 years
- HIPAA
- Research
- Profit sharing
- Wellness program
Quick Apply
Medical Review Nurse -UM/Post Appeals (Michigan RN license req)
Molina Healthcare —Milwaukee, WI
- $29.05 - $67.97 an hour
- Full-time
- RN License
- Mid-level
- Pediatrics
- Health insurance
Case Manager
Advocate Aurora Health —Cudahy, WI
- $38.20 - $57.30 an hour
- Full-time
- Nursing
- RN License
- Hospital
Clinical Quality Specialist - Home Health
Ascension at Home Together with Compassus —Milwaukee, WI
- Full-time
- Nursing
- RN License
- Writing skills
- Tuition reimbursement
Quick Apply
Case Manager
Champion Care —Milwaukee, WI
- $20 - $24 an hour
- Full-time
- Skilled nursing facility
- Mid-level
- Organizational skills
Quick Apply
Clinical Management Manager
Accenture —Milwaukee, WI
- $87,400 - $293,800 a year
- Full-time
- Bachelor's degree
- Travel
- US work authorization
- Paid holidays
- Disability insurance
Integrated Case Manager
Children's Wisconsin —Milwaukee, WI
- Full-time
- Acute care
- Microsoft Word
- Nursing
Physician Urgent Care - Part Time
Children's Wisconsin —Milwaukee, WI
- Part-time
- Acute care
- CPR Certification
- BLS Certification
Registered Nurse Case Manager
Ascension —Mequon, WI
- Part-time
- Nursing
- RN License
- Hospital
- Disability insurance
- Health insurance
Registered Nurse Clinical Manager
Centerwell —West Allis, WI
- $77,200 - $106,200 a year
- Full-time
- CPR Certification
- Nursing
- RN License
- Paid parental leave
- Paid holidays
Registered Nurse (RN) Care Manager
Advocate Aurora Health —Milwaukee, WI
- $38.20 - $57.30 an hour
- Full-time
- Acute care
- Nursing
- RN License
RN Field Case Manager I
CorVel Corporation —Waukesha, WI
- $62,306 - $93,123 a year
- Full-time
- Nursing
- RN License
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
Case Management Director
Champion Care —Milwaukee, WI
- Full-time
- Skilled nursing facility
- RN License
- Mentoring
- Opportunities for advancement
Quick Apply
PHP Clinical Therapist
Granite Hills Hospital —West Allis, WI
- Full-time
- LMFT
- CPR Certification
- Licensed Clinical Social Worker
- Health insurance
- Dental insurance

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utilization review jobs near milwaukee wi

RN DENIALS MANAGEMENT HOURLY

Froedtert Health -
Milwaukee, WI

Apply Now

Job Details

Part-time
$36.38 - $56.39 an hour

Benefits

Continuing education credits
Disability insurance
Relocation assistance
Health insurance
Dental insurance
Tuition reimbursement
Paid time off
Adoption assistance
Employee assistance program
Vision insurance
403(b)
Gym membership
Life insurance
Referral program

Qualifications

RN License
Acute care facility experience
Bachelor's degree

Full Job Description

Discover. Achieve. Succeed. #BeHere

Location: US:WI:MILWAUKEE at our FROEDTERT HOSPITAL facility.

This job is REMOTE.

FTE: 0.500000

Standard Hours: 20.00

Shift: Shift 1

Shift Details:

1/2 day Wednesday, Thursday and Friday

Holidays

: no

Weekends

: no

Job Summary:

Assumes responsibility for managing inpatient denials for all payers related to medical necessity and clinical validation audits, and coordinates the appeal process with physicians, coding, third party payers, and third party auditors. Assists the case managers with utilization review issues, and provides recommendations for process improvement in the areas of utilization review and denial management. Other duties as assigned.

EXPERIENCE DESCRIPTION:

A minimum of 5 years of acute care nursing experience is required. Prior utilization management, insurance background, and denial management experience is preferred.

EDUCATION DESCRIPTION:

Bachelor's degree is required. Professional knowledge of nursing theory and practice at a level normally acquired through completion of a minimum of four years education at an accredited School of Nursing in order to be eligible for licensure as a Registered Nurse is required.

TRAINING DESCRIPTION:

Previous experience with clinical validation denial review and appeal processes. Knowledge of ICD-10 Coding Guidelines.

SPECIAL SKILLS DESCRIPTION:

Interpersonal skills necessary to instruct and maintain effective contacts with a variety of hospital personnel. Analytical skills necessary to prepare statistical reports and develop solutions to problems. Technical writing ability for appeal letters and reports.

LICENSURE DESCRIPTION:

Requires current state of Wisconsin Registered Nurse License or a Multi-state Nursing License from a participating state in the NLC (Nurse Licensure Compact).

Compensation, Benefits & Perks at Froedtert Health

Pay is expected to be between: (expressed as hourly) $36.38 - $56.39. Final compensation is based on experience and will be discussed with you by the recruiter during the interview process.

Froedtert Health Offers a variety of perks & benefits to staff, depending on your role you may be eligible for the following:

Paid time off
Growth opportunity- Career Pathways & Career Tuition Assistance, CEU opportunities
Academic Partnership with the Medical College of Wisconsin
Referral bonuses
Retirement plan - 403b
Medical, Dental, Vision, Life Insurance, Short & Long Term Disability, Free Workplace Clinics

The Froedtert & the Medical College of Wisconsin regional health network is a partnership between Froedtert Health and the Medical College of Wisconsin supporting a shared mission of patient care, innovation, medical research and education. Our health network operates eastern Wisconsin's only academic medical center and adult Level I Trauma center engaged in thousands of clinical trials and studies. The Froedtert & MCW health network, which includes ten hospitals, nearly 2,000 physicians and more than 45 health centers and clinics draw patients from throughout the Midwest and the nation.

We are proud to be an Equal Opportunity Employer who values and maintains an environment that attracts, recruits, engages and retains a diverse workforce. We welcome protected veterans to share their priority consideration status with us at 262-439-1961. We maintain a drug-free workplace and perform pre-employment substance abuse testing. During your application and interview process, if you have a need that requires an accommodation, please contact us at 262-439-1961. We will attempt to fulfill all reasonable accommodation requests.

Apply Now

Refine Your Search

utilization review jobs in milwaukee wi

RN DENIALS MANAGEMENT HOURLY

Visit RN - Weekend Program - ProHealth Home Care and Home Hospice- Benefits Eligible

Supervisor, Healthcare Services (Brown, Fon du Lac, Manitowoc, & Winnebago Counties, WI)

VP, Healthcare Services (Wisconsin)

BH Case Manager: Weekend Program

DIR UTIL REVIEW & DENIALS MGMT ENTERPRISE QUALITY FROEDTERT HOSPITAL REMOTE

Human Resources Generalist

Medical Review Nurse -UM/Post Appeals (Michigan RN license req)

Case Manager

Clinical Quality Specialist - Home Health

Case Manager

Clinical Management Manager

Integrated Case Manager

Physician Urgent Care - Part Time

Registered Nurse Case Manager

Registered Nurse Clinical Manager

Registered Nurse (RN) Care Manager

RN Field Case Manager I

Case Management Director

PHP Clinical Therapist

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