• Outcomes Manager, Utilization Review , RN,…

    Virtua Health (Pennsauken, NJ)
    …team, external physician resource group and payers. Documentation * Appropriate and complete documentation of clinical review and denial management in the case ... Diem Requirement: + 2 shifts per month. + Day before or after holiday, 1 winter and 1 summer. Summary:Responsible for application of appropriate medical… more
    Virtua Health (08/26/25)
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  • Specialty Review Pharmacist

    Access Dubuque (Dubuque, IA)
    Specialty Review Pharmacist **MedOne Pharmacy Benefit Solutions** 1 Positions ID: 3625907 Posted On 10/06/2025 **Job Overview** **Position Overview:** MedOne is ... at the most affordable price. **What You'll Do:** + Evaluate, review and interpret clinical guideline criteria and appropriately utilize clinical knowledge… more
    Access Dubuque (10/07/25)
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  • Clinical Review Pharmacist

    Access Dubuque (Dubuque, IA)
    Clinical Review Pharmacist **MedOne Pharmacy Benefit Solutions** 1 Positions ID: 3625710 Posted On 10/06/2025 **Job Overview** **Position Overview:** MedOne is ... most affordable price. **What You Will Do at MedOne:** + Evaluate, review and interpret clinical guideline criteria and appropriately utilize clinical knowledge and… more
    Access Dubuque (10/07/25)
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  • Data Coordinator/CAD Technician

    JBT Corporation (Lakeland, FL)
    …to the Engineer Manger Major Responsibility Area # 1 : + Maintain robust quality review process for all drawings created, data entered in ERP, and documents ... drafting support to Mechanical Engineering teams. + Provide technical documentation and data entry support to sales...Responsibility Area # 1 : + Maintain robust quality review process for all drawings created, data … more
    JBT Corporation (08/27/25)
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  • Medical Investigator I/II

    Excellus BlueCross BlueShield (Rochester, NY)
    …agencies. Essential Accountabilities: Level I + Functions as a clinical reviewer of medical records, researching and investigating complex medical cases. Interprets ... a clear and concise manner. + Analyzes proactive detection reports and claims data to identify red flags/aberrant billing patterns. + Manages cases as assigned,… more
    Excellus BlueCross BlueShield (09/17/25)
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  • RN Utilization Review Remote

    HonorHealth (AZ)
    …records, finance and physician groups to develop systems to facilitate complete documentation for data reporting purposes. + Initiates chart reviews, conducts ... Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Utilization Review RN Specialist reviews and monitors utilization of health care services… more
    HonorHealth (09/26/25)
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  • Utilization Review Nurse

    University of Utah Health (Salt Lake City, UT)
    …according to state law. Corporate Overview: The University of Utah is a Level 1 Trauma Center and is nationally ranked and recognized for our academic research, ... admissions with associated levels of care and continued stay review . + Communication to third-party payers for initial and...to ensure patient continues to meet medical necessity. + Documentation of all actions and information shared with care… more
    University of Utah Health (10/02/25)
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  • Nurse (Utilization Review Nurse)

    Justice, Bureau of Prisons/Federal Prison System (Rochester, MN)
    …a Bureau of Prisons, Medical Referral Center (MRC). Serves as the Utilization Review Nurse and assists in quality improvement activities through data collection, ... time from designation to arrival; initiation of services and consults; and review of timely care and treatment completes. Responsible for the coordination,… more
    Justice, Bureau of Prisons/Federal Prison System (10/03/25)
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  • Manager, Consumer Credit Review

    American Express (Apex, NC)
    …define the future of American Express. **Position Summary** The Manager, Consumer Credit Review , will perform the Consumer Credit Review function within the ... Express - reporting to the Director of Consumer Credit Review . This position is responsible for delivering end-to-end credit...monitoring, and sampling by working with credit and performance data + Use tools such as SQL, Python, or… more
    American Express (10/02/25)
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  • Engineering Geologist

    The County of Los Angeles (Los Angeles, CA)
    …geology investigationsby acting as project manager, technical lead, technical peer reviewer ; determining needs and requirements pertaining to the investigation (eg, ... (eg, maps, database, aerial photographs, literature, field investigations); compiling data (eg, findings); performing calculations. + Interacts with variety of… more
    The County of Los Angeles (08/31/25)
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