- AmeriHealth Caritas (Philadelphia, PA)
- ** Clinical Care Reviewer , Pediatric Shift Care, Registered Nurse ** Location: Philadelphia, PA Primary Job Function: Medical Management ID**: 34518 Your ... Pediatric Shift Care services. **Education/ Experience:** + Current, active, and unrestricted Registered Nurse licensure in Pennsylvania. + Graduate from an… more
- HCA Healthcare (Corpus Christi, TX)
- …career path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates will ... **Description** **Introduction** **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN you want in your current role? We… more
- Point32Health (MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Clinical Reviewer is a licensed Registered Nurse that is expected ... clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the...+ **EDUCATION:** + Bachelor's degree in Nursing preferred + Registered Nurse with a current and unrestricted… more
- HCA Healthcare (Corpus Christi, TX)
- …career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews & is… more
- HCA Healthcare (Brownsville, TX)
- …Medical Center we support our colleagues in their positions. Join our Team as a(an) RN Clinical Reviewer and access programs to assist with every stage ... benefits may vary by location._ We are seeking a(an) RN Clinical Reviewer for our...to apply for our Sepsis Coordinator Registered Nurse opening. Our team will promptly review … more
- SSM Health (MO)
- …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... the level of services rendered. The CDI Specialist assesses clinical documentation through extensive review of the...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
- HCA Healthcare (Houston, TX)
- …our nurses set us apart from any other healthcare provider. We are seeking a(an) RN Clinical Reviewer to join our healthcare family. **Benefits** Texas ... opportunity! **Job Summary and Qualifications** We are seeking a RN Clinical Reviewer for our...in your career! We are interviewing candidates for our Registered Nurse RN Operating Room… more
- HCA Healthcare (Kingwood, TX)
- …path, we encourage you to apply for our Registered Nurse RN Emergency Department opening. We review all applications. Qualified candidates will be ... **Introduction** Do you have the career opportunities as a(an) RN Clinical Reviewer you want...duties as assigned. What qualification you will need: + Registered Nurse , prefer at least one year… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, ... Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under...ability to lead successful performance improvement projects. Licenses/Certifications Required Registered Nurse ( RN ) - Active,… more
- St. Joseph's Health (Paterson, NJ)
- Bariatric RN Clinical Reviewer - Per diem...of a Bachelor's degree in Nursing. Licensure required as a Registered Nurse by the State of New Jersey. ... Care". Job Overview: The role of the Bariatric Surgery Clinical Reviewer , RN is to...research or medical records experience not mandatory but preferred. Clinical chart review and abstraction experience not… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Part time **Shift:** Rotating Shift **Description:** **JOB SUMMARY** The Clinical Nurse Reviewer 's chief responsibility is to collect ... database of all eligible cases for the hospital. The Clinical Nurse Reviewer also works...CRNA preferred B. Licensure + Licensed in Michigan as registered nurse C. Training and Experience +… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, September 9, 2024 Centers Plan for Healthy Living's ... plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial Adverse… more
- Kepro (ND)
- …being a vital partner for health solutions in the public sector. Acentra is looking for a Nurse ( RN ) Clinical Reviewer to join our growing team. Job ... Summary: Our Nurse Clinical ... Clinical Reviewer will use clinical expertise for the review of medical...remote as long as you have an active unrestricted RN license in the State of North Dakota or… more
- Kepro (SC)
- …being a vital partner for health solutions in the public sector. Acentra is looking for a Clinical UM Reviewer RN to join our growing team. Job Summary: The ... improvement areas. + Maintains current knowledge base related to review processes and clinical practices related to...review processes, functions as the initial resource to nurse reviewers regarding all review process questions… more
- AdventHealth (Bolingbrook, IL)
- …REQUIRED:** . 2 years of RN experience required in a healthcare setting. . Registered Nurse of Illinois, BSN Preferred. . 1 year of experience in a hospital ... caring for:** _AdventHealth Bolingbrook Hospital_ **The role you'll contribute:** This Registered Nurse candidate audits every bariatric surgery patient's Epic… more
- Commonwealth Care Alliance (Boston, MA)
- …Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and ... decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets...Be Doing:** **Essential Duties & Responsibilities:** + Conducts timely clinical decision review for services requiring prior… more
- Commonwealth Care Alliance (Boston, MA)
- …provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key...organizational determinations. **What You'll Be Doing:** + Conducts timely clinical decision review for services requiring prior… more
- Penn State Health (Hershey, PA)
- …Applicants PDF for more detailed steps for assistance._ **Union:** Non Bargained IND456 **Position** RN Registered Nurse Clinical Staff Leader - VARIED ... : Denisse Rosado at ###@pennstatehealth.psu.edu **SUMMARY OF POSITION:** The Registered Nurse Clinical Staff Leader...as a role model for professional nursing practice. The RN Clinical Staff Leader will review… more
- HCA Healthcare (Richmond, VA)
- …apply for our NICU Clinical Coordinator Registered Nurse RN opening. Our team will promptly review your application. Highly qualified candidates will ... in their positions. Join our Team as a(an) NICU Clinical Coordinator Registered Nurse RN and access programs to assist with every stage of your… more
- Centers Plan for Healthy Living (Margate, FL)
- …Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... UM Clinical Reviewer 5297 W Copans Rd,...UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063,...education, and preventative interventions are maintained. Qualifications: + Active RN license, entry level RN welcome +… more