• Clinical Medical Review Nurse

    CareFirst (Cumberland, MD)
    **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider ... programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Clinical Medical Review **Equal Employment Opportunity** CareFirst… more
    CareFirst (11/15/24)
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  • Clinical Review Nurse VHS-…

    Hackensack Meridian Health (Little Falls, NJ)
    …educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed ... issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for...clinical audits. Trend data obtained from reports and review results with managers. + Identify areas for improvement… more
    Hackensack Meridian Health (11/14/24)
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  • Clinical Review Nurse -FT…

    Hackensack Meridian Health (Brick, NJ)
    …educate and support appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review every Medicare and Managed ... issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for...clinical audits. Trend data obtained from reports and review results with managers. + Identify areas for improvement… more
    Hackensack Meridian Health (11/07/24)
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  • Clinical Review Nurse

    Centene Corporation (Reno, NV)
    …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 (11/24/24)
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  • Clinical Review Nurse - Prior…

    Centene Corporation (Sacramento, CA)
    …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 (11/26/24)
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  • Clinical Review Nurse

    Actalent (Atlanta, GA)
    Actalent is currently hiring for Remote Utilization Review RNs! Job Description: + Reviewing authorization requests + Utilizing evidence-based criteria and making a ... if applicable. Qualifications: + Active RN License + Prior Utilization management/Concurrent review experience + Experience with MCG Why Actalent? + Work with a… more
    Actalent (11/14/24)
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  • Registered Nurse Clinical

    CommonSpirit Health Mountain Region (Durango, CO)
    …flourish and leaders who care about your success. Assist with training and coordinating clinical review and quality assurance. Lead and review the ... clinical care and documentation practices related to patients/residents. Review and evaluate quality data to determine areas needing...of the home health and/or hospice patient. + Registered Nurse + Valid CO Driver's License. + BLS Sedentary… more
    CommonSpirit Health Mountain Region (11/23/24)
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  • Clinical Coding Appeals Nurse

    R1 RCM (Boise, ID)
    …AI, intelligent automation, and workflow orchestration. As our ** Clinical Coding Appeals Nurse ** , you will help review and interpret medical records to ... production-drive position. **Here's what you will experience working as a Clinical Coding Appeals Nurse :** + Review and interpret medical records to appeal… more
    R1 RCM (11/22/24)
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  • Supervisor Clinical Pharmacist…

    Prime Therapeutics (Columbus, OH)
    …Description Summary** This position has managerial and clinical oversight of the Clinical Pharmacist and Registered Nurse Review Team, playing a key ... drives every decision we make. **Job Posting Title** Supervisor Clinical Pharmacist Review - Remote in California...the clinical performance of a team of Clinical Pharmacist and Nurse Reviewers while supporting… more
    Prime Therapeutics (10/22/24)
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  • Clinical Nurse Coord Nurse

    HCA Healthcare (San Antonio, TX)
    …step in your career path, we encourage you to apply for our Clinical Nurse Coord Nurse opening. We review all applications. Qualified candidates will be ... **Description** **Introduction** Do you have the career opportunities as a(an) Clinical Nurse Coord Nurse you want in your current role? We invest in what… more
    HCA Healthcare (11/12/24)
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  • Float Pool Clinical Nurse

    HCA Healthcare (Austin, TX)
    …step in your career path, we encourage you to apply for our Float Pool Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a(an) Float Pool Clinical Nurse Coordinator you want in your current role? We invest in… more
    HCA Healthcare (11/09/24)
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  • Dialysis Clinical Nurse Coordinator

    HCA Healthcare (Austin, TX)
    …step in your career path, we encourage you to apply for our Dialysis Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a(an) Dialysis Clinical Nurse Coordinator you want in your current role? We invest in… more
    HCA Healthcare (11/02/24)
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  • Emergency Room Clinical Nurse

    HCA Healthcare (Austin, TX)
    …in your career path, we encourage you to apply for our Emergency Room Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Introduction** Do you have the career opportunities as an Emergency Room Clinical Nurse Coordinator you want in your current role? We invest in what… more
    HCA Healthcare (11/09/24)
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  • ICU Clinical Nurse Coordinator

    HCA Healthcare (San Antonio, TX)
    …next step in your career path, we encourage you to apply for our ICU Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a(an) ICU Clinical Nurse Coordinator you want in your current role? We invest in what… more
    HCA Healthcare (11/15/24)
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  • Medical ICU Clinical Nurse

    HCA Healthcare (San Antonio, TX)
    …step in your career path, we encourage you to apply for our Medical ICU Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Introduction** Do you have the career opportunities as a(an) Medical ICU Clinical Nurse Coordinator you want in your current role? We invest in what… more
    HCA Healthcare (11/04/24)
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  • RN Medsurg Clinical Nurse

    HCA Healthcare (Myrtle Beach, SC)
    …step in your career path, we encourage you to apply for our RN Medsurg Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Introduction** Do you have the career opportunities as a **RN Medsurg Clinical Nurse Coordinator** you want in your current role? We invest in what… more
    HCA Healthcare (11/19/24)
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  • Psychiatric Clinical Nurse

    HCA Healthcare (Richmond, VA)
    …step in your career path, we encourage you to apply for our Psychiatric Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a(an) Psychiatric Clinical Nurse Coordinator you want in your current role? We invest in… more
    HCA Healthcare (11/19/24)
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  • Ortho Trauma PCU Clinical Nurse

    HCA Healthcare (Plano, TX)
    …in your career path, we encourage you to apply for our Ortho Trauma PCU Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** ** Clinical Nurse Coordinator / CNC -...**Description** ** Clinical Nurse Coordinator / CNC - Orthopedic Trauma PCU**...have the career opportunities as an Ortho Trauma PCU Clinical Nurse Coordinator you want in your… more
    HCA Healthcare (10/30/24)
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  • Surgical Oncology Clinical Nurse

    HCA Healthcare (Plano, TX)
    …in your career path, we encourage you to apply for our Surgical Oncology Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** ** Clinical Nurse Coordinator - Surgical Oncology** **Shift: Full time - Nights** **Location: Medical City Plano Hospital** **Introduction** Do… more
    HCA Healthcare (10/30/24)
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  • Ortho Trauma PCU Clinical Nurse

    HCA Healthcare (Plano, TX)
    …in your career path, we encourage you to apply for our Ortho Trauma PCU Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** ** Clinical Nurse Coordinator / CNC -...**Description** ** Clinical Nurse Coordinator / CNC - Orthopedic Trauma PCU**...have the career opportunities as an Ortho Trauma PCU Clinical Nurse Coordinator you want in your… more
    HCA Healthcare (09/03/24)
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