• Registered Nurse Clinical Reviewer

    HCA Healthcare (Corpus Christi, TX)
    …path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates will be contacted ... **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN you want in...Center Bay Area!** **Job Summary and Qualifications** **The Quality Review Nurse position encompasses multiple responsibilities including… more
    HCA Healthcare (11/01/24)
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  • RN - Clinical Nurse Reviewer

    Trinity Health (Livonia, MI)
    …Type:** Part time **Shift:** Rotating Shift **Description:** **JOB SUMMARY** The Clinical Nurse Reviewer 's chief responsibility is to collect and submit reliable ... of all eligible cases for the hospital. The Clinical Nurse Reviewer also works closely with the...Word, Excel, PowerPoint) and web-based applications. + Clinical chart review and abstraction experience required + Database data entry… more
    Trinity Health (09/11/24)
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  • Nurse Reviewer I (NCLEX)

    Elevance Health (San Juan, PR)
    …organization, providing information technology and business operations services for health plans._ ** Nurse Reviewer I** **Location:** This position will work a ... time zones that the unit will be supporting. The ** Nurse Reviewer I** is responsible for conducting...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review more
    Elevance Health (11/27/24)
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  • Medicare Nurse Reviewer

    Medical Mutual of Ohio (OH)
    …Medicare Supplement, and individual plans. Under limited supervision, the Medicare Nurse Reviewer applies medical necessity guidelines in making authorization ... Nursing Board. Bachelor's degree preferred. + 3 years as a Registered Nurse with a combination of clinical and or utilization/case management experience, preferably… more
    Medical Mutual of Ohio (11/20/24)
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  • RN Registered Nurse Clinical…

    Trinity Health (Livonia, MI)
    …Type:** Full time **Shift:** Day Shift **Description:** + The MTQIP Clinical Reviewer (MCR) is responsible for collecting, analyzing, and reporting clinical data ... Act, or SJMHS's Return to Work Program_ **The RN Clinical Reviewer Required Education, Experience, and** **Certification/Licensure** + Ten years minimum of… more
    Trinity Health (10/30/24)
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  • Fire Plan Reviewer

    Lee County Board of County Commissioners (Fort Myers, FL)
    Fire Plan Reviewer Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/4735880) Apply  Fire Plan Reviewer Salary $24.86 - $52.12 Hourly ... + Benefits + Questions Description JOIN OUR TEAM AS A FIRE PLAN REVIEWER ! Lee County Community Development is committed to ensuring the safety and compliance… more
    Lee County Board of County Commissioners (11/21/24)
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  • RN Clinical Reviewer

    HCA Healthcare (Corpus Christi, TX)
    …next step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates ... Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews & is… more
    HCA Healthcare (09/24/24)
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  • Nurse Reviewer

    Elevance Health (Lakewood, WA)
    …Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. + Partners ... information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review of exception… more
    Elevance Health (11/26/24)
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  • RN Clinical Reviewer

    HCA Healthcare (Webster, TX)
    …support our colleagues in their positions. Join our Team as a(an) RN Clinical Reviewer and access programs to assist with every stage of your career. **Benefits** ... and job skills. Apply today for our RN Clinical Reviewer opening and continue to learn! **Job Summary and...+ Bachelor's Degree in Nursing required. + Current Registered Nurse License in the State of Texas or Multi-State… more
    HCA Healthcare (10/30/24)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …For 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, Margate, FL 33063,...to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to… more
    Centers Plan for Healthy Living (11/06/24)
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  • RN Clinical Reviewer

    HCA Healthcare (Kingwood, TX)
    …step in your career path, we encourage you to apply for our Registered Nurse RN Emergency Department opening. We review all applications. Qualified candidates ... you have the career opportunities as a(an) RN Clinical Reviewer you want in your current role? We invest...as assigned. What qualification you will need: + Registered Nurse , prefer at least one year of experience +… more
    HCA Healthcare (11/27/24)
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  • Utilization Management Reviewer

    Blue Cross Blue Shield of Massachusetts (Hingham, MA)
    …healthcare? Bring your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who may have complex ... the following personas: eWorker, mobile and resident. The Team The Clinical Utilization Reviewer is part of a highly dedicated and motivated team of professionals,… more
    Blue Cross Blue Shield of Massachusetts (10/25/24)
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  • Reviewer I, Medical

    ManpowerGroup (Columbia, SC)
    **Title: Medical Reviewer ** **Location:** **4101 Percival Road Columbia SC 29229 US (Onsite)** **Duration: 03+ Month's Contract** **Shift: Monday to Friday, 8 AM - 5 ... $20.00 to $23.00/hr.** We are looking for a "Medical Reviewer " to join one of our Fortune 500 clients....of our Fortune 500 clients. **Job Summary** The Medical Review and Utilization Management Specialist is responsible for performing… more
    ManpowerGroup (10/22/24)
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  • Bariatric RN Clinical Reviewer - Per diem

    St. Joseph's Health (Paterson, NJ)
    Bariatric RN Clinical Reviewer - Per diem Job ID2024-25808 LocationPaterson, New Jersey ShiftPer Diem - Nursing Apply Now ... (https://careers-sjhmc.icims.com/jobs/25808/bariatric-rn-clinical- reviewer per-diem/login) Apply Now (Internal Candidate) Save This Job Job Saved Overview St.… more
    St. Joseph's Health (09/18/24)
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  • Remote Clinical Quality Reviewer

    Chenega Corporation (NM)
    …Services** ' company, is looking for a fully remote **Clinical Quality Reviewer ** to ensure compliance with the contract, and program requirements for Clinical ... national, TRICARE, and URAC standards for consistency. Supports activities of peer review and quality and safety committees. Our company offers employees the… more
    Chenega Corporation (11/26/24)
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  • DRG Validator & Appeals Reviewer -Clinical…

    MetroHealth (Cleveland, OH)
    …of additional comorbid conditions. Conducts concurrent and retrospective medical record review on defined patient populations to identify opportunities to improve ... years of CDI experience or; - CDI Second Level Reviewer with a strong understanding of disease processes, clinical...licensed or licensed by endorsement as a LPN, Registered Nurse , MD or MD equivalent. Minimum 5 years acute… more
    MetroHealth (11/07/24)
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  • HMSA Care Manager - BH, UM Reviewer

    Magellan Health Services (Honolulu, HI)
    …quality of care. General Job Information Title HMSA Care Manager - BH, UM Reviewer - Remote Hawaii Grade 24 Work Experience - Required Clinical Work Experience - ... - Care Mgmt, LSW - Licensed Social Worker - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred… more
    Magellan Health Services (11/21/24)
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  • Quality Clinical Reviewer , Licensed/Remote…

    Magellan Health Services (Johnstown, PA)
    …skills and demonstrated experience. General Job Information Title Quality Clinical Reviewer , Licensed/Remote in PA (Cambria Cty) Grade 25 Work Experience - ... Therapist - Care Mgmt, PSY - Psychologist - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred… more
    Magellan Health Services (11/10/24)
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  • RN Clinical Documentation Specialist, First…

    SSM Health (MO)
    …services rendered. The CDI Specialist assesses clinical documentation through extensive review of the medical record, interaction with physicians, nursing staff, ... accurate clinical documentation and correct negative trends. Communicates with physicians, nurse practitioners, case managers, coders and other members of the care… more
    SSM Health (09/05/24)
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  • Reviewer I, Medical

    US Tech Solutions (Columbia, SC)
    …of service or due date to determine the priority of our cases. Then we review the requests against the policy and the member's contract. When reviewing the clinical ... level. If not, then it would be sent for review with our medical director. We would then complete...compact multistate unrestricted LPN license as defined by the Nurse Licensure Compact (NLC), OR, active, unrestricted LBSW (Licensed… more
    US Tech Solutions (11/27/24)
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