Short Hills, New Jersey, United States · Remote OK
Position Summary The Utilization Review (UR) Clinical lead serves as a subject matter expert in utilization management and hospital revenue cycle operations. This role partners directly with large hospital systems to ass…
Skills: Utilization Review, Denial Management, Hospital Revenue Cycle, Case Management, Clinical Consulting
Short Hills, New Jersey, United States • Remote OK
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Serve as a clinical consultant for hospital systems to optimize utilization review and denial management processes. Partner with executive leadership to improve authorization workflows, reduce denials, and ensure regulatory compliance.
Requires a Registered Nurse (RN) license with at least 7 years of experience in Utilization Review, Case Management, or Revenue Cycle. Must have at least 3 years of client-facing consulting experience with hospital systems.
Position Summary
The Utilization Review (UR) Clinical lead serves as a subject matter expert in utilization management and hospital revenue cycle operations. This role partners directly with large hospital systems to assess, optimize, and support utilization review and denial management initiatives.
The ideal candidate is a licensed clinician with strong utilization review experience and the ability to work directly with executive and operational leaders within healthcare organizations. This position requires a consultative mindset, excellent communication skills, and the ability to influence change while driving measurable outcomes for clients.
Essential Responsibilities
Experience
Knowledge & Skills
Qualifications
Education
Licensure
Travel Requirements
Healthcare Solutions
At HURC, we're Operators. Not Platforms. We give providers the advantage in Utilization Review, alleviate the burden of resource challenges, discover yield-loss & maximize Net Patient Revenue through Clinical Revenue Cycle services, and provide the operational insights to scale - all while bridging the payer gap to the advantage of providers.
Offices: 2600 Morris Tpke, Short Hills, New Jersey, US
Healthcare Solutions
At HURC, we're Operators. Not Platforms. We give providers the advantage in Utilization Review, alleviate the burden of resource challenges, discover yield-loss & maximize Net Patient Revenue through Clinical Revenue Cycle services, and provide the operational insights to scale - all while bridging the payer gap to the advantage of providers.
Offices: 2600 Morris Tpke, Short Hills, New Jersey, US
