- Centene Corporation (Sacramento, CA)
- …with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners and works with Medical Affairs and/or ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review (West Coast) Job Description We are seeking a dedicated Clinical Review Nurse to perform ... with at least 2 years in acute care. + Strong skills in clinical review , utilization management, and concurrent review . + Self-starter with excellent time… more
- Children's Mercy Kansas City (Kansas City, MO)
- …improve the lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, evidence-based ... from admission through hospital stay to discharge. Adeptly uses evidence based clinical practice guidelines to determine the appropriate level of care and the… more
- Elevance Health (Louisville, KY)
- ** Clinical Review Nurse I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... Medicare and Medicaid Services to transform federal health programs. The ** Clinical Review Nurse** is responsible for reviewing and making medical determinations… more
- IQVIA (Durham, NC)
- …(DOC) or Data Team Lead (DTL)). Essential Functions: + Serve independently as a Clinical Data Coder, Lead Coder and/or Coding reviewer for one or more ... (DM) team to meet sponsor and company needs. Perform Clinical Data Management (CDM) Coding activities, and provide leadership...in the role of a Lead Coder or Coding Reviewer or as an individual Subject Matter Expert (SME)… more
- Centene Corporation (New York, NY)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
- Centene Corporation (Sacramento, CA)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... current CA license.** **Must have** **2-4 years related** **experience in UM-Concurrent Review . 2+ years of acute care experience required. 10% Travel required.**… more
- UCLA Health (Los Angeles, CA)
- …with healthcare standards and regulations. This role involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement ... thorough facility site reviews and medical record audits, including inspections of clinical areas, patient care practices, and administrative processes + Review … more
- UCLA Health (Santa Monica, CA)
- …for the identification, collection, and entry of quality data for the Clinical Registries, Patient Safety Indicators (PSIs), and Hospital Acquired Conditions (HACs) ... program.This will involve applying your clinical knowledge to analyze data and identify trends and...improvement. You will serve as a liaison between the clinical stakeholders, clinical registries, and outsourced registry… more
- Lilly (Indianapolis, IN)
- …development of clinical strategies, development plans and study protocol design. ** Clinical Research/Trial Execution and Support** + Review and approve local ... (for example, sample size, patient dedication, timelines, grants, and governance review interactions). + Collaborate with clinical research staff, regional… more