• Clinical Reviewer Utilization…

    US Tech Solutions (Canton, MA)
    …possible extension)** Notes: Fully remote, MA license required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- ... more
    US Tech Solutions (03/06/25)
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  • RN Clinical Reviewer

    HCA Healthcare (Alexandria, LA)
    **Description** **Rapides Regional Medical Center** **RN Clinical Reviewer ** **Full Time, Days, No Weekends** Do you currently have an opportunity to make a real ... more
    HCA Healthcare (03/21/25)
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  • RN Clinical Reviewer PRN

    HCA Healthcare (Alexandria, LA)
    **Description** **Rapides Regional Medical Center** **RN Clinical Reviewer ** **PRN** Rapides Regional Medical Center is committed to investing in the latest ... more
    HCA Healthcare (03/21/25)
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  • Bariatric Clinical Reviewer RN

    AdventHealth (Daytona Beach, FL)
    …Medical Parkway, Daytona Beach, FL 32117 **The role you'll contribute:** The Bariatric Clinical Reviewer -RN will be responsible to collect and submit accurate, ... more
    AdventHealth (03/08/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #664 Monday, December 2, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... more
    Centers Plan for Healthy Living (03/04/25)
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  • Registered Nurse Clinical Reviewer

    HCA Healthcare (Houston, TX)
    …apart from any other healthcare provider. We are seeking a(an) Registered Nurse Clinical Reviewer to join our healthcare family. **Benefits** The Woman's ... more
    HCA Healthcare (03/16/25)
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  • Surgical Clinical Reviewer - General…

    Hartford HealthCare (Hartford, CT)
    …care and more than 30 different specialties. *_ Job Description_* The Surgical Clinical Reviewer 's (SCR) chief responsibility is to collect and submit reliable ... more
    Hartford HealthCare (03/29/25)
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  • Clinical Documentation Specialist 2…

    University of Miami (Hialeah, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... more
    University of Miami (02/05/25)
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  • Registered Nurse Clinical Reviewer

    HCA Healthcare (Corpus Christi, TX)
    …step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates ... more
    HCA Healthcare (01/31/25)
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  • Registered Nurse Clinical Reviewer

    HCA Healthcare (Conroe, TX)
    …step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates will ... more
    HCA Healthcare (03/11/25)
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  • Clinical Documentation Specialist, Second…

    SSM Health (MO)
    …Qualifications:** + CCDS certification + Prior experience as a Second Level Reviewer + Prior experience reviewing PSI (patient safety indicator) or experience with ... more
    SSM Health (03/19/25)
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  • Clinical Utilization Reviewer , LPN

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …benefits, as well as regulatory and NCQA requirements. + Refer to RN or PT Clinical Utilization reviewer for more complex cases as appropriate or when question ... more
    Blue Cross Blue Shield of Massachusetts (02/25/25)
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  • Clinical Appeals Reviewer

    AmeriHealth Caritas (Philadelphia, PA)
    …Discover more about us at www.amerihealthcaritas.com. **About this job:;** **;** The Clinical Appeals Reviewer is responsible for processing appeals and ensuring ... more
    AmeriHealth Caritas (03/29/25)
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  • RN Outpatient Reviewer , Precertification…

    Point32Health (MA)
    …day in service to our members, partners, colleagues and communities. **Job Summary** The Clinical Reviewer is a licensed Registered Nurse that is expected to ... more
    Point32Health (02/08/25)
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  • RN MDS Reviewer

    Commonwealth Care Alliance (Boston, MA)
    …monitoring. The RN MDS Reviewer is a member of the Minimum Data Set (MDS) Clinical Review team of the Care Planning Unit. The RN MDS Reviewer supports ... more
    Commonwealth Care Alliance (01/24/25)
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  • Behavioral Health Utilization Management…

    AmeriHealth Caritas (Charleston, SC)
    …and providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer 's discretion to retain ... more
    AmeriHealth Caritas (03/18/25)
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  • RN- Clinical Documentation Specialist,…

    SSM Health (MO)
    …mortality reviews. **Required Qualifications:** + 12 months of experience as a Clinical Documentation Specialist + Graduate of accredited school of nursing, PA, NP, ... more
    SSM Health (03/19/25)
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  • Speech Therapist / Clinical Reviewer

    The Cigna Group (Bloomfield, CT)
    …with the department Director. Responsible to perform prospective, retrospective and concurrent review consistent with eviCore clinical review protocols and ... more
    The Cigna Group (03/29/25)
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  • Clinical Professional RN Clinical

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: High-level clinical review of patients admitted to the University Hospital for the purpose of risk identification and referral to clinical ... more
    SUNY Upstate Medical University (01/03/25)
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  • Genetic Counselor Reviewer

    Elevance Health (Rancho Cordova, CA)
    …or requires physician review or override. + Clearly and concisely documenting clinical review and other case interactions in online database in adherence to ... more
    Elevance Health (03/15/25)
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