• Medical Claim Review Nurse

    Molina Healthcare (Salt Lake City, UT)
    …state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate… more
    Molina Healthcare (08/08/25)
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  • Utilization Review Medical Director

    Commonwealth Care Alliance (Boston, MA)
    …to the Senior Medical Director of Medical Policy and Utilization Review , the Utilization Review Medical Director will be responsible for providing ... **Essential Duties & Responsibilities:** + Primary responsibility for performing daily medical reviews, appeals as appropriate, correspondence regarding review more
    Commonwealth Care Alliance (06/27/25)
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  • Registered Nurse Peer Review

    AdventHealth (Ocala, FL)
    …the analysis of events that require peer review and the examination of medical records as identified by clinical indicators or triggers is an integral part ... The Coordinator Professional Practice Evaluation is responsible for facilitating the medical staff Peer Review , Ongoing Professional Practice Evaluation (OPPE)… more
    AdventHealth (08/08/25)
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  • Flight Registered Nurse ( RN

    Vighter Medical Group (Jacksonville, FL)
    Flight Registered Nurse ( RN ), Jacksonville, FL Job...to their countries of origin. The RN will review medical records to determine if ... - Jacksonville, FL Position Type Full Time Education Level Registered Nurse ( RN ) Salary Range...Customs Enforcement. Healthcare is delivered in accordance with approved medical protocols and in compliance with Department of Homeland… more
    Vighter Medical Group (07/01/25)
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  • Utilization Review Specialist RN

    Houston Methodist (Sugar Land, TX)
    registered nurse ( RN ) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care ... determines the appropriateness of inpatient or observation services following review of relevant medical documentation, medical...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/29/25)
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  • Utilization Review Nurse

    Houston Methodist (Houston, TX)
    registered nurse ( RN ) who comprehensively conducts point of entry and concurrent medical record review for medical necessity and level of care ... Houston Methodist, the Utilization Review Nurse (URN) position is a licensed ...in case management **LICENSES AND CERTIFICATIONS - REQUIRED** + RN - Registered Nurse -… more
    Houston Methodist (07/25/25)
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  • RN Registered Nurse

    Henry Ford Health System (Grand Blanc, MI)
    Registered Nurse - Medical ...tests ordered are expeditiously carried out and documented. + Review patient medical record /reports and ... will be considered the official job description. Education/Experience Requirements + Licensed Registered Nurse credentialed from the Michigan Board of Nursing… more
    Henry Ford Health System (06/23/25)
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  • Registered Nurse I, RN I…

    State of Colorado (Golden, CO)
    Registered Nurse I, RN I...(DYS) policy. Documents all encounters with youth in electronic medical records system and/or appropriate medical ... Mountain, Youth Services Center - Golden Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5008113) Apply  Registered Nurse I, RN I -… more
    State of Colorado (07/16/25)
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  • Registered Nurse RN Cardiac…

    HCA Healthcare (Blacksburg, VA)
    …you to apply for our Registered Nurse RN Cardiac Medical Unit opening. We review all applications. Qualified candidates will be contacted by a ... have the career opportunities as a Registered Nurse RN Cardiac Medical Unit...and timely documentation of care administration in the patient's medical record . - Administer prescribed medications, monitor… more
    HCA Healthcare (07/26/25)
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  • Special Investigation Unit (SIU) Coding…

    CVS Health (Bismarck, ND)
    …legal, compliance, or rework projects. + Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates ... + A minimum of 5 years of experience in medical record review for coding...the ability to mentor and develop team members. + Registered Nurse ( RN ). + Previous… more
    CVS Health (08/08/25)
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