- Trinity Health (Springfield, MA)
- …weekly supervision of Clinical Case Coordinators and provides supervision to the clinical team during clinical review meetings. + Reviews treatment goals ... Health Of New England is looking for an experienced ** Clinical Case Supervisor** to come join our team. Brightside...by being there to offer support and encouragement. The ** Clinical Care** **Supervisor** **is a master's Level and Licensed… more
- CaroMont Health (Gastonia, NC)
- …Management, Quality and/or Case Management preferred. Minimum of three years experience in clinical area with clinical review experience. Requires excellent ... Job Summary: Completes initial review for medical necessity for all admissions in...utilization regarding level of patient care, diagnostic testing, and clinical procedures without jeopardizing patient quality efforts. Identifies and… more
- CVS Health (Columbus, OH)
- …role in ensuring members receive timely, medically necessary care through thoughtful clinical review and collaboration with providers. This fully remote position ... in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan… more
- Texas Health Resources (Arlington, TX)
- …Remote (Local candidates only) Work hours: Monday - Friday from 8:00am - 4:30pm Clinical Review and Denials Department highlights: + Flexible schedule + Remote ... Clinical Reviews, Denial and Appeals RN Bring your...necessary research for appealing denied days/stays through electronic record review . Requires access to Care Connect patient records for… more
- UC Health (Cincinnati, OH)
- …of direct support personnel who are completing precertification and follow up work through clinical review , appeal letters, and provision of drug information or ... Services Hours: Full-Time, 40 Hours/Weekly Shift: First UC Health is hiring a Clinical Staff Pharmacist for the Medication Access Services Pharmacy Department at the… more
- Health Advocates Network (Brooklyn, NY)
- …the initial evaluation + Conducts clinically sound risk evaluations including clinical review , applying risk assessment protocols, pertinent data/chart reviews, ... Health Advocates Network is seeking a **Licensed Clinical Social Worker (LCSW)** to work at a...assess, diagnose and manage the presenting symptoms + Writes clinical reports regarding diagnoses and prognoses and develops treatment… more
- Health Advocates Network (Polkton, NC)
- …the initial evaluation + Conducts clinically sound risk evaluations including clinical review , applying risk assessment protocols, pertinent data/chart reviews, ... Health Advocates Network is currently seeking a **Licensed Clinical Social Worker** to work at a correctional...assess, diagnose and manage the presenting symptoms + Writes clinical reports regarding diagnoses and prognoses and develops treatment… more
- Health Advocates Network (Ione, CA)
- …the initial evaluation + Conducts clinically sound risk evaluations including clinical review , applying risk assessment protocols, pertinent data/chart reviews, ... Health Advocates Network is seeking a **Licensed Clinical Social Worker (LCSW)** to work at a...assess, diagnose and manage the presenting symptoms + Writes clinical reports regarding diagnoses and prognoses and develops treatment… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …as appropriate. In collaboration with clinical leaders, provides weekly and daily clinical review of the surgical schedule to ensure procedures are posted ... to the entering and updating of scheduling data, monitoring, clinical verification, confirming and publishing the final procedural area...communicates changes to physicians, clinical offices and others… more
- Houston Methodist (Houston, TX)
- …Collaborates with revenue cycle regarding any claim issues or concern that may require clinical review during the pre-bill, audit, or appeal process. + Secures ... At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed...delivery settings and recommends alternatives, if appropriate, by analyzing clinical protocols. Reviews H&Ps and admitting orders of all… more