- Point32Health (MA)
- …who we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Clinical Reviewer is a licensed Registered Nurse that is expected ... a clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the determination of medical necessity and,… more
- Rush University Medical Center (Chicago, IL)
- …1** **Work Schedule:** 8 Hr (9:00:00 AM - 5:00:00 PM) **Summary:** The Surgical Clinical Reviewer 's chief responsibility is to oversee and optimize the American ... of Surgery, and other applicable Rush entities. The Surgical Clinical Reviewer is responsible for the technical...creation of patient-tracking Excel documents. * Conducts a regular review with the Clinical Quality Program Manager… more
- Geisinger (Danville, PA)
- Job Summary A clinical concurrent reviewer applies clinical and coding knowledge to concurrently evaluate the clinical indicators, diagnoses, and ... reviewer (CDI SLR) is an advanced concurrent reviewer who uses his/her extensive Clinical Documentation...opportunities. The CDI SLR will also respond to concurrent review requests from Clinical Documentation Integrity Specialists,… more
- Kepro (CA)
- …a vital partner for health solutions in the public sector. Acentra seeks a Utilization Clinical Reviewer to join our growing team in California. Job Summary As a ... Utilization Clinical Reviewer , you'll harness your expertise to...the accuracy and consistency of the Psychiatric Inpatient Concurrent Review process in alignment with the California Mental Health… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, September 9, 2024 Centers Plan for Healthy Living's goal ... plans they need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial Adverse… more
- HCA Healthcare (Houston, TX)
- …environment where diversity and inclusion thrive? Submit your application for our RN Clinical Reviewer opening with HCA Houston Healthcare Northwest today and ... may vary by location._ We are seeking a(an) RN Clinical Reviewer for our team to ensure...to apply for our Stroke Coordinator opening. We promptly review all applications. Highly qualified candidates will be directly… more
- HCA Healthcare (Brownsville, TX)
- …Center we 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. ... may vary by location._ We are seeking a(an) RN Clinical Reviewer for our team to ensure...Sepsis Coordinator Registered Nurse opening. Our team will promptly review your application. Highly qualified candidates will be contacted… more
- HCA Healthcare (Corpus Christi, TX)
- …step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates will ... you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your current...including Core Measure chart abstraction, Stroke & STEMI chart review and coordination; performs concurrent chart reviews & is… more
- Prime Therapeutics (Columbus, OH)
- …fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer - GI- REMOTE **Job Description Summary** Key member of the ... clinical determinations cannot be made by the Initial Clinical Reviewer . + Discusses determinations with requesting...as needed to discuss cases and problems. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Kepro (ND)
- …growing team. Job Summary: Our Nurse Clinical Reviewer will use clinical expertise for the review of medical records against appropriate criteria in ... Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver… more
- Centers Plan for Healthy Living (Margate, FL)
- UM Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #664 Monday, September 9, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help… more
- Evolent Health (Columbus, OH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer you will be a key member of the utilization management team. ... Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that do not initially meet... rationale for standard and expedited appeals. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- LA Care Health Plan (Los Angeles, CA)
- Utilization Management Clinical Quality Nurse Reviewer RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 ... the safety net required to achieve that purpose. Job Summary The Utilization Management Clinical Quality Nurse Reviewer RN II, under the purview the Utilization… more
- HCA Healthcare (Houston, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) RN Clinical Reviewer to join our healthcare family. **Benefits** Texas Orthopedic Hospital, ... - and empowers their passion for patient care. Apply today for our Clinical Reviewer opportunity! **Job Summary and Qualifications** We are seeking a RN … more
- Evolent Health (Columbus, OH)
- …the mission. Stay for the culture. **What You'll Be Doing:** As a Oncology, Physician Clinical Reviewer you will be a key member of the utilization management ... Will Be Doing:** + Serve as the specialty match reviewer in Oncology cases, that do not initially meet...within the regulatory timeframe of the request. + Utilizes medical/ clinical review guidelines and parameters to assure… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Part time **Shift:** Rotating Shift **Description:** **JOB SUMMARY** The Clinical Nurse Reviewer 's chief responsibility is to collect and ... database of all eligible cases for the hospital. The Clinical Nurse Reviewer also works closely with...software (Microsoft Word, Excel, PowerPoint) and web-based applications. + Clinical chart review and abstraction experience required… more
- HCA Healthcare (Weatherford, TX)
- **Description** **Medical City Weatherford** **RN Clinical Reviewer ** **Full Time - Days** **Monday - Friday** **8am-5pm** **Introduction** Last year our HCA ... us reach our goals. Unlock your potential! **Job Summary and Qualifications** The Clinical Data/ Core Measures Abstractor (CD/CMA) at WRMC is responsible for working… more
- St. Joseph's Health (Paterson, NJ)
- Bariatric RN Clinical Reviewer - Per diem Job ID2024-25808 LocationPaterson, New Jersey ShiftPer Diem - Nursing Apply Now ... Care". Job Overview: The role of the Bariatric Surgery Clinical Reviewer , RN is to collect and...research or medical records experience not mandatory but preferred. Clinical chart review and abstraction experience not… more
- University of Miami (Hialeah, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Concurrent Quality Reviewer of our hospital reviews documentation in the electronic...the computer assisted coding software, recognizing inappropriate application of clinical coding regulations/guidelines, and revising the codes assigned based… more
- HCA Healthcare (Corpus Christi, TX)
- …step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer PRN opening. We review all applications. Qualified candidates ... **Description** **Introduction** **Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer PRN you want in your current role? We invest… more