- HCA Healthcare (Austin, TX)
- …Manager using facility approved audit tools. As the NICU Clinical Nurse Reviewer , . You will review patient's medical record and documents' compliance of ... medical records to ensure the standard of care is provided. The RN Clinical Reviewer is responsible for the analysis of the medical accord and then documenting… more
- Hartford HealthCare (Hartford, CT)
- …different specialties. The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely ... data registry activities, including program teleconferences and meetings. Maintains Surgical Clinical Reviewer (SCR) certification on an annual basis, in… more
- St. Luke's University Health Network (Bethlehem, PA)
- …of a patient's ability to pay for health care. The Admission's Clinical Reviewer is responsible for the comprehensive medical review and screening of all ... and responds to all inquiries for admission to ARC + Completes thorough review of documentation and information and assesses a patient's appropriateness for ARC… more
- Centers Plan for Healthy Living (Margate, FL)
- …applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine medical… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview: ;** The Clinical Appeals Reviewer is responsible for processing appeals and ensuring all milestones are met in compliance with regulatory ... a case for determination, interacting directly with providers to obtain additional clinical information, and with members or their advocates to understand the full… more
- Healthfirst (NY)
- **Duties//Responsibilities:** + The Medical Peer Reviewer will assess// review requests for authorization, and claims payment, based on medical records and ... internal Healthfirst information and make informed clinical judgments and recommendations. + The Medical Peer ...clinical judgments and recommendations. + The Medical Peer Reviewer will render determinations in the format and within… more
- AmeriHealth Caritas (Lafayette, LA)
- …clinical criteria. Using professional judgment, the Utilization Management Reviewer assesses the appropriateness of services, identifies care coordination ... When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical leadership in other areas of BCBSMA. The ... your true colors to blue. The Role The Physician Reviewer is responsible for evaluating clinical service...anticipatory case management for members whose cases come for review , in partnership with case managers + Participate in… more
- Catalent Pharma Solutions (Morrisville, NC)
- …accurately and precisely represent the work done during production. The Batch Record Reviewer is responsible for executing the review and successful release of ... **Batch Record Reviewer ** **Position Summary** + **Shift:** Monday-Friday 6am-2:30pm or...is home to Catalent's Inhalation franchise including product development, clinical and commercial manufacturing for pMDI, DPI and Nasal… more
- SSM Health (MO)
- …an auditor, and an educator ensuring medical records are complete and clinical documentation comprehensively represents the current health status of network patients ... and electronic health record charts that accurately capture the clinical picture. **Job Responsibilities and Requirements:** PRIMARY RESPONSIBILITIES + Reviews… more