- UTMB Health (Galveston, TX)
- …(CCS) certification, and a minimum of 3 years of medical coding experience. **Or** . Registered nurse (or medical school graduate) with a minimum of 3 years ... Clinical Documentation Specialist ( Remote -Texas Resident)...UTMB Health Requisition # 2507161 **Minimum Qualifications:** . Certified Registered Health Information Administrator (RHIA), Technician (RHIT), or an… more
- CVS Health (Columbus, OH)
- …high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team **Position Summary** The Team Lead ... including extended periods of sitting, computer use, and document review . + Participate in occasional on-call rotations, including some...managed care organization (MCO). + Experience in a high-volume clinical call center or prior remote work… more
- CVS Health (Phoenix, AZ)
- …Information** Schedule: Monday-Friday 8:00am-5:00pm AZT (No weekends or holidays) Location: 100% Remote (Must have Arizona RN license or compact license that ... in the lives of patients? Join Mercy Care as a Utilization Management Clinical Consultant and become part of a mission-driven team that's transforming healthcare for… more
- Molina Healthcare (Kearney, NE)
- JOB DESCRIPTION **Job Summary** The RN Clinical Appeals Nurse provides support for internal appeals clinical processes - ensuring that appeals requests ... a plus. Work hours: Monday - Friday 8:00am- 5:00pm Remote position **Essential Job Duties** * Performs clinical...or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must… more
- Trinity Health (Columbus, OH)
- …in lieu of an RN . + Licensure/Certification: Current license to practice as registered nurse in the State of Ohio. Registered Health Information ... **Employment Type:** Part time **Shift:** Day Shift **Description:** The Clinical Documentation Specialists will concurrently review medical...Specialist (CCS) will be considered in lieu of a RN . + Experience: Minimum of 5 years acute care… more
- Highmark Health (Dover, DE)
- …Work **LICENSES OR CERTIFICATIONS** **Required** + Required (any of the following): + Registered Nurse + Licensed Social Worker (LSW) - Non-Specific + Licensed ... Audit Reviews, Annual MERCER Review and NCQA Review . Develops ongoing educational programs that ensures clinical...Therapist (LMFT) - Non-Specific + Current State of PA RN licensure OR Current multi-state licensure through the enhanced… more
- Trinity Health (Livonia, MI)
- …or Nursing or equivalent in experience. Must possess one of the below: + Current Registered Nurse ( RN ) License + Registered Health Information ... Full time **Shift:** Day Shift **Description:** **POSITION PURPOSE** Work Remote Position At the direction of the Regional Manager,...regulatory standards are met. Ensures that direct reports perform clinical validation as part of the review … more
- Cognizant (Salem, OR)
- …to be considered** + Educational background - Registered Nurse ( RN ) + 2-3 years combined clinical and/or utilization management experience with managed ... **Location:** Remote **About the role** As a Registered Nurse you will make an impact...as well as timely filing deadlines and processes. + Review clinical denials including but not limited… more
- Martin's Point Health Care (Portland, ME)
- …management experience in a managed care setting including utilization review + RN experience in a clinical setting + Leadership and/or management experience ... Supervisor is responsible for day-to-day operations of the utilization review clinical team, in the areas of...Required License(s) and/or Certification(s): + Current Licensure as an RN in Maine and other appropriate jurisdictions as necessary… more
- UTMB Health (Galveston, TX)
- QAPI Clinical Service Ln Mgr ( RN ) Partial Remote (Sealy Heart & Vasc. Inst. - Galveston) **Galveston, Texas, United States** Nursing & Care Management UTMB ... REGISTRATIONS OR CERTIFICATIONS** Required: Valid state of Texas Professional Nursing ( RN ) license or clinical program professional registration Preferred: Six… more
- Fujifilm (Phoenix, AZ)
- …where appropriate. + Participates in professional organizations. + Provides telephone and remote clinical support for customers, sales, and field service via ... **Position Overview** The Clinical Consultant, MI - I shall be responsible...experience in: + MPI + MUGA + PET + (CV) Registered Nurse Cardiac experience in: + Cath,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Clinical Guide Location: Remote Career Area: Health Services About Blue ... difference, join us. The Impact You Will Have The Clinical Guide is a critical component of BCBSMs Integrated... and service availability. Required Skills and Experience * RN with MN license or LSW with no restrictions… more
- Beth Israel Lahey Health (Burlington, MA)
- …States for consideration** The Clinical Documentation Improvement (CDI) Specialist Registered Nurse ( RN ) assists with the appropriate identification ... (SOI), Risk of Morality (ROM), during an inpatient hospitalization. CDI Specialist RN initiates concurrent queries to providers as supported by medical record… more
- Northwell Health (Garden City, NY)
- …a HCS-D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for OASIS Specialist- Clinical . Remote position Job Responsibility 1.Leverages clinical ... combination of education and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State required, plus specialized… more
- Beth Israel Lahey Health (Charlestown, MA)
- …Education: Bachelor's in Nursing, required Licensure, Certification & Registration: + RN License + Clinical Documentation Specialist Certification via ACDIS ... making a difference in people's lives.** **This position is remote . Candidates must be local to New England States...be local to New England States for consideration** The Clinical Documentation Improvement (CDI) Specialist II assists with the… more
- SSM Health (IL)
- …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... **It's more than a career, it's a calling.** IL- REMOTE **Worker Type:** PRN **Pay Range:** $35.81 -...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
- SSM Health (MO)
- …Division of Professional Registration + Or + Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by Compact State + Or + Registered ... **It's more than a career, it's a calling.** MO- REMOTE **Worker Type:** Regular **Job Summary:** Performs as...+ Physician - Regional MSO Credentialing + Or + Registered Nurse ( RN ) Issued by… more
- LA Care Health Plan (Los Angeles, CA)
- Registered Nurse ( RN ) Manager, Appeals and Grievances General Operations ( Clinical ) Job Category: Clinical Department: CSC Appeals & Grievances ... + Excellent verbal, written communication and presentation skills. Licenses/Certifications Required Registered Nurse ( RN ) - Active, current and… more
- University of Virginia (Culpeper, VA)
- …Nurse Program. Experience: * None required. Licensure: * Licensed to practice as a Registered Nurse ( RN ) in the Commonwealth of Virginia prior to ... the hiring manager or recruiter for more details. The RN is responsible for providing clinical support...as establishing IV access, and Urinary Cath + Perform clinical prep to review records and studies,… more
- Ochsner Health (Slidell, LA)
- …in the hospital. Works closely with Departments to identify opportunities for clinical quality improvement and other special projects as may be identified. To ... including one year experience in hospital surgery department, surgery clinic, clinical research or medical records. **Certifications** Required - Current RN… more
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