- System One (Baltimore, MD)
- …requirements. + Medical Record Retrieval, Abstraction and Research during the Medical Record Review Project + Medical Record Retrieval for ... overreads in line with NCQA guidelines. Additional tasks involve helping with Medical Record Retrieval for HEDIS and Risk Adjustment, participating in internal… more
- HCA Healthcare (Chattanooga, TN)
- …is your next step in your career path, we encourage you to apply for our Medical ICU Nurse opening. We review all applications. Qualified candidates will be ... for Eligible Full Time Hires** Do you have the career opportunities as a(an) Medical ICU Nurse you want in your current role? We invest in what matters most to… more
- Rising Medical Solutions (Chicago, IL)
- …too. In fact, that's how our business was born - and continues to thrive. Rising Medical Solutions is looking for a Nurse Auditor who wants to make their mark ... Join our team and maximize client savings by reviewing medical bills from a nurse perspective, including...in acute care, surgery and/or orthopedic + Workers' Compensation medical bill review experience a major plus… more
- Sioux City Community School District (Sioux City, IA)
- …Maintain accurate health records for students served, including Medicaid documentation as required. Review medical orders with school nurse to guide the ... or procedures on a daily basis due to significant medical needs. Facilitate positive student responses to development; promote...medical matters under the direction of the school nurse and administration. Provide health care for chronic and… more
- HCA Healthcare (Charleston, SC)
- …path, we encourage you to apply for our Medical Surgical Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Introduction** Do you have the career opportunities as a Medical Surgical Registered Nurse you want in...admissions, testing and discharges . You will maintain and review patients' records including posting tests and examination results… more
- HCA Healthcare (Plano, TX)
- …path, we encourage you to apply for our Medical Oncology Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Description** **Registered Nurse / RN - Medical Oncology** **Shift: Full time - Nights** **Location: Medical City Plano hospital** **Introduction** Do you… more
- HCA Healthcare (Austin, TX)
- …we encourage you to apply for our Seasonal Medical Surgical Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Introduction** Do you have the career opportunities as a(an) Seasonal Medical Surgical Registered Nurse you want in your current role? We invest in what… more
- HCA Healthcare (Plano, TX)
- …path, we encourage you to apply for our Medical Oncology Registered Nurse opening. We review all applications. Qualified candidates will be contacted by ... **Description** **Registered Nurse / RN - Medical Oncology** **Shift: Full time - Nights** **Location: Medical City Plano Hospital** **Introduction** **Do… more
- Children's Hospital Boston (Boston, MA)
- …representative of the ED Psychiatry team, with the medical team and charge nurse to review and coordinate plans for patients boarding in the emergency ... 76115BRJob Posting Title:Psychiatric Nurse Practitioner, Emergency Department *$5,000 sign-onDepartment:Psychiatry and Behavioral Sciences… more
- The Arora Group (Bethesda, MD)
- Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed Practical Nurse (LPN/LVN) - Utilization Review in Bethesda, ... required on Federal holidays. DUTIES OF THE LICENSED PRACTICAL NURSE (LPN/LVN) - UTILIZATION REVIEW : + Initiate,...clinical information and may also provide education on the medical review process. + The Contractor performing… more
- State of Georgia (Thomas County, GA)
- Registered Nurse (Regional Quality Review (RQR)) - Region 4 Georgia - Thomas - Thomasville ... located in downtown Atlanta. Job Description Job Title: Registered Nurse ( Regional Quality Review (RQR) )...aimed at assessing the quality of the environment, health, medical supports and community integration of the individual. .… more
- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as a member of a team responsible for ensuring the ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as… more
- LA Care Health Plan (Los Angeles, CA)
- Facility Site Review Nurse Specialist RN II Job... Specialist RN II conducts Full Scope Reviews, Site Review Surveys, Medical Record Review ... Category: Clinical Department: Facility Site Review Location: Los Angeles, CA, US, 90017 Position Type:...Review (FSR) Nurse...Off (PTO) + Tuition Reimbursement + Retirement Plans + Medical , Dental and Vision + Wellness Program + Volunteer… more
- Travelers Insurance Company (Buffalo, NY)
- …Imagine loving what you do and where you do it. **Job Category** Claim, Nurse - Medical Case Manager **Compensation Overview** The annual base salary range ... Is the Opportunity?** This position is responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective,… more
- Virtua Health (Marlton, NJ)
- …that supports the diagnosis and treatment of the patient.Collaborates with Physicians, Medical Directors, Quality Directors, Case Managers, Nurse Directors and ... of action plans to improve outcomes.Position Responsibilities:* Evaluates and analyzes medical records concurrently for proper documentation. This review … more
- Actalent (Dallas, TX)
- …ensure timely review of services and/or requests. + Assess the medical necessity of care in coordination with healthcare providers and interdepartmental teams. + ... Job Title: Prior Authorization NurseJob Description The Prior Authorization Nurse is responsible for analyzing all prior authorization requests to determine the … more
- InnovaCare (San Juan, PR)
- …to the business. MMM Holdings, Inc.Job Description Inpatient Unit POSITION: Concurrent Review Nurse (CRN) POSITION DESCRIPTION Manages the inpatient utilization ... visits to Acute, SNF, and Rehabilitation Inpatient facilities to concurrently review admissions and continued stay to determine appropriate Utilization, Quality… more
- Centene Corporation (Austin, TX)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... competitive benefits including a fresh perspective on workplace flexibility. **Registered Nurse Strongly Preferred** **Must reside and be licensed in the state of… more
- Actalent (Omaha, NE)
- …to claims and preauthorization processing. This role involves accurate and timely medical review of claims, preauthorizations, and customer service inquiries. ... We are seeking a dedicated and detail-oriented Utilization Management Nurse to join our team. The ideal candidate will...medical policy. + Verify member eligibility prior to medical review . + Foster constructive relationships with… more
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