• Clinical Review Coordinator

    BrightSpring Health Services (Oklahoma City, OK)
    …nationwide through our growing network of branches and healthcare professionals. The Clinical Review Coordinatorwill support the new referral process / patient ... onboarding experience by assisting the Clinical Review team in gathering and obtaining missing information needed to initiate care. The Clinical Review more
    BrightSpring Health Services (12/18/24)
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  • Clinical Review Manager, Hospice…

    VNS Health (Manhattan, NY)
    OverviewThe Hospice Clinical Review Manager's primary responsibility is ensuring compliance with local coverage determinants (LCD) in coding and documentation ... in the EHR, when generating the Plan of Care Order for hospice. The Hospice Clinical Review Manager is an integral part of the QAPI team and assists in … more
    VNS Health (12/05/24)
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  • Abstractor- Clinical Review Advanced…

    Baptist Memorial (Memphis, TN)
    …education + Employee referral program Job Summary: Position: 3337 - Abstractor- Clinical Review Advanced Facility: BMHCC Corporate Office Department: HS ... (3) years? clinical experience in inpatient cardiovascular care setting. Clinical chart review and abstraction experience. Special Skills Preferred: Data… more
    Baptist Memorial (11/17/24)
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  • Clinical Review Nurse I

    Elevance Health (Louisville, KY)
    ** Clinical Review Nurse I** **National Government Services** is a proud member of Elevance Health's family of brands. We administer government contracts for ... Friday 8 am - 5 pm EST or CST. Hours are flexible.** The ** Clinical Review Nurse I** is responsible for reviewing and making medical determinations as to whether… more
    Elevance Health (01/08/25)
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  • Clinical Review Specialist

    Gentiva (Mooresville, NC)
    …a lasting difference in people's lives every day. **Overview** We're looking for a ** Clinical Review Specialist** to join our team. You will directly report to ... the Clinical Review Specialist Team Lead and AVP...the Clinical Review Specialist Team Lead and AVP of Regulatory Affairs....Hospice and Home Care experience with one year of clinical record review and QAPI **We Offer**… more
    Gentiva (01/04/25)
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  • RN Clinical Review Management

    St. Luke's Health System (Twin Falls, ID)
    **Overview** At St. Luke's, our dedicated team of Clinical Review Nurses strive to build a positive, supportive, and inclusive culture that delivers exceptional ... **Category** _Nursing - RN and Leadership_ **Work Unit** _Clinical Review Management System Office_ **Position Type** _Full-Time_ **Work Schedule** _VARIABLE_… more
    St. Luke's Health System (12/19/24)
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  • Clinical Quality Review Specialist…

    Trinity Health (Livonia, MI)
    …**Shift:** **Description:** Trinity Health at Home is seeking an experienced RN remote Clinical Quality Review Specialist with ICD10 HCS-D certification which is ... of hire **Trinity Health at Home is seeking an experienced RN Clinical Quality Review Specialist for a remote position** **ICD10 HCS-D certification which is… more
    Trinity Health (12/10/24)
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  • Utilization Review Clinical

    Community Health Systems (Franklin, TN)
    …with the physicians on the medical staff hospital's to perform an internal secondary review . The UR Clinical Specialist may assist coordinating a Peer to Peer ... in the case management system by the UR Behavioral Health Review Specialist. + UR Clinical Specialist communicates with the UR Coordinator and facility case… more
    Community Health Systems (01/08/25)
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  • Clinical Review Nurse - Prior…

    Centene Corporation (Raleigh, NC)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
    Centene Corporation (01/10/25)
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  • Clinical Review Specialist II…

    UCLA Health (Santa Monica, CA)
    …for the identification, collection, and entry of quality data for the Clinical Registries, Patient Safety Indicators (PSIs), and Hospital Acquired Conditions (HACs) ... program.This will involve applying your clinical knowledge to analyze data and identify trends and...improvement. You will serve as a liaison between the clinical stakeholders, clinical registries, and outsourced registry… more
    UCLA Health (12/12/24)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Honolulu, HI)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
    Centene Corporation (01/10/25)
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  • Clinical Scientist

    Catalyst Clinical Research LLC (Raleigh, NC)
    …will also be responsible for communicating and presenting the relevant trends/findings of the clinical review to the Study Team and the Client. In collaboration ... meet contracted project timeline and Client expectations as they relate to the clinical review of data. You will rise to the Chief Medical Officer, Clinical more
    Catalyst Clinical Research LLC (12/10/24)
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  • Clinical Director, RN (Monmouth County)

    Hackensack Meridian Health (Wall, NJ)
    … results with staff and develop action plans for improvement. Responsible for clinical review . Implement action plans and complete trending reports. Attends and ... the Conditions of Participation (COPs). + Oversee recruiting of clinical staff. Review staffing and develop appropriate staffing plan to accomplish organization… more
    Hackensack Meridian Health (12/27/24)
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  • Executive Medical Director, Oncology…

    Takeda Pharmaceuticals (Boston, MA)
    …of logistics study planning and implementation + Consistent with membership of the Clinical Review Board Committee, responsible for critical review of ... Strategy (IDAS) and overall Integrated Global Development Plan (IGDP). Responsible for review of synopses, other relevant clinical study documents and Critical… more
    Takeda Pharmaceuticals (12/21/24)
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  • Lead Physician Medical Services (Fort Logan) Open…

    University of Colorado (Aurora, CO)
    …and facility leadership. + Manages the Institute's outside medical process through clinical review and authorization of services. Assesses and recommends ... **Lead Physician Medical Services (Fort Logan) Open Rank-Sr Instructor Sr. Clinical Instructor** **Description** **University of Colorado | CU Anschutz Medical… more
    University of Colorado (12/08/24)
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  • Registered Nurse Clinical Appeal & Claim

    Medical Mutual of Ohio (OH)
    …provider community, explaining processes for accessing health plan to perform clinical review , identifying appropriate community resources, or otherwise ... We are looking for applicants that have a strong clinical utilization management background. Medicare experience is a plus....care + Extrapolates and summarizes medical information for physician review or other external review + Generates… more
    Medical Mutual of Ohio (01/03/25)
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  • RN Clinical Resource Manager

    AdventHealth (Hinsdale, IL)
    …Resource Manager provides leadership and consultation to company facilities in the clinical review , evaluation and procurement of products and leads ... committees.** **The value you'll bring to the team:** + **Facilitates clinical teams to review utilization and options for product selection for our Great Lakes… more
    AdventHealth (11/26/24)
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  • Supervisory Health Technician (Telehealth…

    Veterans Affairs, Veterans Health Administration (Poplar Bluff, MO)
    …tasks such as capturing images, collecting data and transmitting them electronically for clinical review in accordance with VHA national guidelines. Ensure that ... Summary This position serves as the Supervisory Health Technician ( Clinical Telehealth) at the John J. Pershing VAMC as the direct supervisor of a team of Health… more
    Veterans Affairs, Veterans Health Administration (01/08/25)
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  • Clinical Quality and Safety Specialist I

    UCHealth (Aurora, CO)
    …in establishing trigger lists and meeting structure o Reviews and triages cases for clinical review o Promotes use of Just Culture o Supports a multidisciplinary ... metrics o Identifies areas of opportunity in partnership with clinical experts * Collaborative Case Review (CCR)...approach of clinical review * Agile MD Pathways o...approach of clinical review * Agile MD Pathways o Assists in the… more
    UCHealth (12/17/24)
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  • Clinical Coordinator Infusion Services

    Penn Medicine (Philadelphia, PA)
    …to evaluate infusion orders to ensure regulatory compliancePerformance Expectations: Performs clinical review of new infusion orders to determine request ... Summary: + With guidance from the Systems Director and Associate Clinical Director, this position will review infusion therapy orders to ensure that a drug is… more
    Penn Medicine (11/24/24)
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