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1–3 jobs· newest first

Utilization Review Liaison
Avenues Recovery · Clarksville, US
Competitive Compensation
Clinical Denial Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ
Capital Health (US) · Lawrenceville, US
$20–$26Full-time
Home Health Registered Nurse Clinical Manager
AdvisaCare · Flint, US
Competitive salary

+10K new in the last hour

Utilization Review Liaison

Avenues Recovery · Posted Nov 6, 2026

Clarksville, Indiana, United States
Competitive Compensation
1+ years

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Support clinical operations, documentation compliance, and utilization review processes in a behavioral health setting.

Responsibilities

Conduct regular chart audits to ensure documentation accuracy, completeness, and compliance with company, payer, and regulatory standards.
Monitor clinical and operational processes to identify opportunities for improvement.
Track missing documentation and ensure timely completion of all required chart elements.
Support quality assurance initiatives and maintain adherence to accreditation and compliance requirements.
Serve as a liaison between clinical staff, facility leadership, and the Utilization Review department.

Requirements

High School Diploma
GED
Nice to have: knowledge of medical terminology
Nice to have: clinical documentation
Nice to have: utilization review processes

Skills

medical terminology clinical documentation utilization review processes

Benefits

Generous Paid Time Off
401(k) with Company Match
Medical, Dental & Vision Insurance
Employer-Paid Life & AD&D Insurance
Short- and Long-Term Disability Options

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Clinical Denial Specialist - FT - Day - Revenue Integrity & Denials Mgmt Lawrenceville NJ

Capital Health (US) · Posted Oct 29, 2026

Lawrenceville, New Jersey, United States
Full-time
$20–$26 per hour
3+ years

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Compensation

Pay Range: $20.10 - $26.13

Responsibilities

Reviews and triages inpatient clinical denials, including medical necessity, patient status, and readmission-related denials
Routes cases to appropriate clinical resources based on denial type and appeal viability
Maintains accurate inpatient clinical denial inventories, including deadlines, appeal levels, documentation status, and outcomes
Coordinates medical record requests, appeal packet preparation logistics, and submission tracking
Ensures compliance with payer requirements, timelines, and documentation standards for inpatient clinical denials

Requirements

High school diploma or equivalent
Associate degree in healthcare or business-related field
Bachelor’s degree in healthcare or business-related field

Skills

Inpatient clinical denial categories Utilization review processes Documentation workflows Tracking and inventory management

Home Health Registered Nurse Clinical Manager

AdvisaCare · Posted Nov 5, 2026

Flint, Michigan, United States
Competitive salary
1–2 years

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Lead and support the Home Health team as a Clinical Manager, overseeing clinical operations, compliance, quality initiatives, and patient outcomes.

Responsibilities

Provide clinical leadership and supervision to home health staff, including RNs, LPNs, and aides.
Ensure compliance with Medicare Conditions of Participation, accreditation standards, and agency policies.
Review and monitor clinical documentation for accuracy, completeness, and regulatory compliance.
Support the development and implementation of patient-centered care plans.
Oversee OASIS accuracy, timeliness, and quality improvement initiatives.

Requirements

Graduate of an accredited nursing program
Nice to have: Previous supervisory or management experience
Nice to have: Experience with EMR/EHR systems used in home health
Nice to have: Knowledge of quality improvement and utilization review processes
Nice to have: Familiarity with accreditation standards (CHAP, ACHC, Joint Commission)

Skills

Registered Nurse (RN) license Home health nursing experience Knowledge of Medicare home health regulations

Root cause analysis

Written communication

Hospital billing systems

Microsoft Office Excel

Microsoft Office

Benefits

Medical Plan
Prescription drug coverage & In-House Employee Pharmacy
Dental Plan
Vision Plan
Flexible Spending Account (FSA)

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EMR/EHR system experience

Quality improvement processes

Utilization review processes

Accreditation standards (CHAP, ACHC, Joint Commission)

Benefits

Competitive salary
Health, dental, and vision insurance
Paid time off and holidays
401(k) with company match
Continuing education opportunities

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