- CareFirst (Cumberland, MD)
- **Resp & Qualifications** **PURPOSE:** The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider ... appeals that require medical review to determine if the claim...possess excellent verbal and written communication skills. **Licenses/Certifications** : RN - Registered Nurse -… 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
- St. Luke's Health System (Boise, ID)
- …of the department, including organizing and conducting programs and establishing procedures for medical staff peer review functions across the health system. + ... Liaison and resource for medical staff peer review committees and the...seekers. **Default: Location : City** _Boise_ **Category** _Nursing - RN and Leadership_ **Work Unit** _Practitioner Peer Review… more
- Trinity Health (Springfield, MA)
- …program. BSN graduate preferred, Master's preferred + **Licensure** : Current Licensure as a Registered Nurse RN in Massachusetts. + **Certification** : BLS ... BSN At **Mercy Medical Center** the **Utilization Review /Appeals & Denials** ** RN ** performs utilization ...determinations using screening criteria, and assists the physician, bedside Registered Nurse , ICC and Social Worker with… more
- The Arora Group (Bethesda, MD)
- …guidelines. + The Contractor shall frequently collaborate with managers of the UBO, Utilization Review Registered Nurse ( RN ) and pre-certification clerk. ... Licensed Practical Nurse (LPN) - Utilization Review Nurse Currently recruiting a Licensed...clinical information and may also provide education on the medical review process. + The Contractor performing… more
- Prime Healthcare (Ontario, CA)
- …leadership, hospital C-suite and Clinical departments including Clinical Documentation Improvement, Medical Review and Appeals, Business Office and Clinical ... Doctor or Graduate of an accredited school of nursing and currently licensed as a Registered Nurse required. 3. Minimum of 10 years of experience in healthcare.… more
- CaroMont Health (Gastonia, NC)
- …daily reviews of medical necessity will be performed and documented in medical review , including daily status update while patient is in observation status. ... Job Summary: Completes initial review for medical necessity for all...accredited college with a clinical background. BSN required. Current RN license to practice in NC (NC license or… more
- Vighter Medical Group (Mesa, AZ)
- Flight Registered Nurse ( RN ) - IWA Job...DHS/ICE detainees being repatriated to their countries of origin. The RN will review medical records to ... Job Location Mesa, AZ - Mesa, AZ Education Level Registered Nurse ( RN ) Travel Percentage...correctional health environment + Assumes responsibility as the sole medical provider of care for Federal detainees with stable,… more
- UCLA Health (Los Angeles, CA)
- …The Department of Medicine is seeking to hire a dynamic and experienced Peer Review RN Coordinator to drive excellence in quality improvement for our Ambulatory ... expertise will be essential as you manage the end-to-end peer review process-from data analysis and medical record review to facilitating impactful review… more
- HCA Healthcare (Margate, FL)
- …career path, we encourage you to apply for our Registered Nurse RN Medical Telemetry opening. We review all applications. Qualified candidates will ... **Description** **Introduction** Do you have the career opportunities as a(an) Registered Nurse RN Medical Telemetry you want in your current role? We… more
- Dayton Children's Hospital (Dayton, OH)
- …timeHours:40Job Details:Under the supervision of the Manager of Utilization Management, the Utilization Review RN conducts medical record review for ... Epic Systems (preferred) Education Requirements: Bachelors: Nursing (Required) Certification/License Requirements: [Lic] RN : Registered Nurse ( RN ) - Ohio… more
- Helio Health Inc. (Syracuse, NY)
- …healthcare issues. In order to support our mission, Helio Health is seeking a Registered Nurse ( RN )to work on aFull-Timebasis for ourPersonalized Recovery ... Oriented Services (PROS). The Registered Nurse ( RN ) will provide...for medical services. + Develop, recommend, and review medical policies and procedures for all… more
- Hackensack Meridian Health (Belle Mead, NJ)
- …+ Master's Degree **Licenses and Certifications Preferred:** + NJ State Professional Registered Nurse License or NJ Licensed Social Worker **Job ID** ... caseload. Collaborates with the attending LIP, Clinical Case Manager, nurse , and other members of the treatment team, ACCESS...the treatment team, Director of Utilization Management, and the Medical Director. + Review charts at identified… more
- Fresenius Medical Center (Corpus Christi, TX)
- **POSITION FEATURES:** AZURA **PURPOSE AND SCOPE:** A Certified Registered Nurse Anesthetist (CRNA) in an advanced practice registered nurse (APRN) who ... meetings and other management meetings upon request from the Medical Director. + Review and comply with...by the National Board of Certification and Recertification for Nurse Anesthetists. + Insurable by an appropriate medical… more
- HCA Healthcare (St. Petersburg, FL)
- …you to apply for our RN Registered Nurse Medical Surgical Telemetry opening. We review all applications. Qualified candidates will be contacted ... the career opportunities that you want in your current RN role? We invest in what matters most to...and Qualifications** We are seeking a Registered Nurse to join our "3-North" Cardiac Medical … more
- HCA Healthcare (Blacksburg, VA)
- …you to apply for our Registered Nurse RN Medical Surgical Unit opening. We promptly review all applications. Highly qualified candidates will ... work environment where diversity and inclusion thrive? Submit your application for our Registered Nurse opening with LewisGale Hospital Montgomery today and find… more
- Henry Ford Health System (Grand Blanc, MI)
- …RN ) nursing program; must possess current Michigan licensure to practice as a registered nurse ( RN ). + Essential Functions: + Interpersonal skills ... Registered Nurse - Med Surg Float...tests ordered are expeditiously carried out and documented. + Review patient medical record/reports and confers with… more
- Geisinger (Bloomsburg, PA)
- …and License(s) Basic Life Support Certification - Default Issuing Body; Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE & ... criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through defined processes,… more
- Geisinger (Scranton, PA)
- …Experience Minimum of 3 years-Nursing (Required) Certification(s) and License(s) Licensed Registered Nurse (Pennsylvania) - RN_State of Pennsylvania OUR PURPOSE ... criteria, reporting potential risk and quality management issues identified from medical record review to appropriate departments through defined processes,… more
- HCA Healthcare (Richmond, VA)
- …encourage you to apply for our Registered Nurse RN Medical Surgical and Trauma opening. We review all applications. Qualified candidates will be ... **Description** **Introduction** Do you have the career opportunities as a Registered Nurse RN Medical Surgical and Trauma you want in your current role?… more
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