- AdventHealth (Orlando, FL)
- …Shift **The role you'll contribute:** Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the ... Clinical Documentation Integrity Manager, and in collaboration with physicians,...with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality… more
- Actalent (Memphis, TN)
- …training. Required Skills & Experience + Minimum 1 year of experience as a Registered Nurse . + Strong clinical skills in oncology and wound care. + Proficiency ... Job Title: Registered Nurse - Wound Care Specialist Location: Memphis, TN...patient-centered care, focusing on wound treatment and recovery. Your clinical knowledge and compassionate approach will help improve patient… more
- Rochester Regional Health (Rochester, NY)
- …Care SCHEDULE: Days, Monday-Friday ATTRIBUTES + At least two (2) years of full-time clinical experience as a Nurse Practitioner in a primary care site required ... SUMMARY As a Nurse Practitioner, your superior interpersonal and empathetic skills,...system pay practices. This may include: productivity and/or value-based clinical incentives, bonus compensation, or other forms of variable… 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
- Independent Health (Buffalo, NY)
- …benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Clinical Reviewer will be responsible for the collection and review ... support of a high performing health plan and physician network. The Clinical Reviewer will investigate quality complaints/grievances and appeals, document… more
- AdventHealth (Tampa, FL)
- …failure, cancer and other diseases. **The role you'll contribute:** The Utilization Management nurse uses clinical expertise to review patient records in ... Research Institute, also located at AdventHealth Tampa, leads the way in clinical and academic research in the areas of neuroscience, cardiovascular medicine,… more
- Sunnyside Nursing and Post-Acute Care (Torrance, CA)
- …of infection control practices. + Other duties as directed by the Chief Clinical Officer/ Regulatory Compliance Nurse or Executive director. Requirements + Must ... Ombudsman, Health Department. + Management of the facility's mock survey process. Review findings and initiate plans for implementation. + Management on CMS critical… more
- Centers Plan for Healthy Living (Margate, FL)
- …for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help identify and ... 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
- Magellan Health Services (Albuquerque, NM)
- …experience. Strong interpersonal and organizational skills. General Job Information Title Senior Quality Clinical Reviewer - BH - Remote, NM Grade 26 Work ... Health experience preferred. This is a remote position. Applies clinical expertise in conducting standardized independent reviews of case management… more