- Elevance Health (Roanoke, VA)
- …+ Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. ... **Nurse Reviewer I** **Location** : This role enables associates...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial … more
- Elevance Health (Houston, TX)
- …clinical information presented meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity ... **Nurse Reviewer Associate** **Location:** This role enables associates to...member of the Elevance Health family of companies, **Carelon Medical Benefits Management,** formerly AIM Specialty Health, is a… more
- RWJBarnabas Health (New Brunswick, NJ)
- …one year experience in a hospital surgery department, clinic, clinical research or medical records , Clinical chart review and abstraction experience ... New Brunswick, NJ 08901 Job Title: ACS Surgical Case Reviewer Location: Main Hospital - New Brunswick Department Name:...and other special projects as may be identified, Will review charts for Mortality and Morbidity in addition to… more
- State of Massachusetts (Westborough, MA)
- …providers and integrated care plans to evaluate quality of care, medical necessity, program eligibility, health and safety, care planning, clinical documentation, ... care, interview providers and MassHealth members and their caregivers, and review clinical documentation Providing training, coaching, and other feedback to LTSS… more
- Carle Health (Peoria, IL)
- …Arts (LPHA) authorizing Integrated Assessment and Treatment Plans. Will complete thorough review of each document, provide clinical guidance to team members, and ... ensure compliance with IATP standards. LPHA reviewer provides behavioral health assessment, intervention, and consultation to individuals and/or groups identified as… more
- Volunteers of America Los Angeles (Los Angeles, CA)
- …PURPOSE Under the direction of a Quality Assurance Coordinator, the Quality Assurance Reviewer II performs Quality Assurance review and audit of VOALA Program ... Quality Assurance Reviewer II Location:Los Angeles, CA Job ID:3903 Salary:$29.18...PAY RATE:$29.18 - $30.72 Per Hour BENEFITS:VOALA offers competitive medical , dental, vision and retirement benefits. JOB SUMMARY AND… more
- Evolent (Jefferson City, MO)
- …with a company behind it. **What You'll Be Doing:** Job Description As a Clinical Reviewer , Nurse, you will be a key member of the utilization management team. We ... while providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse, you will routinely interact with leadership and management… more
- NTT DATA North America (IL)
- … Reviewer - State of IL Position Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS quality ... the assignment. This position interprets relevant clinical criteria through review of medical records , annotates...offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters… more
- Elevance Health (Chicago, IL)
- **Appeals Nurse Reviewer I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... A proud member of the Elevance Health family of companies, **Carelon Medical Benefits Management** , formerly AIM Specialty Health, is a benefit-management leader… more
- Centene Corporation (Indianapolis, IN)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... on workplace flexibility. **Remote Opportunity** **Centene is Hiring - Remote Psychologist Reviewer (ABA)** **Centene is seeking a Remote Psychologist Reviewer … more