• Claim Benefit Specialist- Medical Reviewer

    CVS Health (Franklin, TN)
    …policyholders and beneficiaries to ensure accurate and timely handling of the medical review process. Contributes to the efficient and accurate handling ... team processes, and effective communication skills. **A Brief Overview** Performs medical records ordering and review , verifies policy coverage, evaluate… more
    CVS Health (11/20/25)
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  • Medical Director

    Centene Corporation (Salem, OR)
    …management, cost containment, and medical quality improvement activities + Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services, ensuring timely and quality decision making. + Supports effective implementation… more
    Centene Corporation (11/19/25)
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  • Medical Director, Psychiatry (SafetyNet…

    Excellus BlueCross BlueShield (Buffalo, NY)
    …management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for… more
    Excellus BlueCross BlueShield (11/12/25)
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  • Physician - CA Medical Clinic, Onsite

    Sandia National Laboratories (Livermore, CA)
    …performing medical examinations for commercial drivers + Current certification as Medical Review Officer for reviewing drug testing results + Working ... of onsite work and working from home) + Generous vacation, strong medical and other benefits, competitive 401k, learning opportunities, relocation assistance and… more
    Sandia National Laboratories (11/27/25)
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  • Medical Director

    Centene Corporation (Raleigh, NC)
    …management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for… more
    Centene Corporation (11/19/25)
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  • Medical Director, North Carolina

    Centene Corporation (Raleigh, NC)
    …management, cost containment, and medical quality improvement activities. Performs medical review activities pertaining to utilization review , quality ... medical review of complex, controversial, or experimental medical services. Supports effective implementation of performance improvement initiatives for… more
    Centene Corporation (10/15/25)
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  • Medical Staff Services Coordinator

    HCA Healthcare (Manchester, NH)
    …membership or clinical privileges, as directed by facility leaders. Catholic Medical Center 6. Performance Improvement/Peer Review /Patient Safety Coordinate with ... external peer reviews. Complete a summary of FPPE, OPPE, and peer review results for evaluation by medical staff leaders as part of the R-RFC process as noted in… more
    HCA Healthcare (11/10/25)
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  • Utilization Review Nurse Supervisor I

    The County of Los Angeles (Los Angeles, CA)
    …staff training is needed, and to make recommendations on potential areas for medical care evaluation studies. + Attends Utilization Review Committee meetings to ... OPTION I:One year of experience performing the duties of a Utilization Review Nurse* or Medical Service Coordinator, CCS.** -OR- OPTION II: Two (2) years of… more
    The County of Los Angeles (10/06/25)
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  • Utilization Review Nurse Supervisor II

    The County of Los Angeles (Los Angeles, CA)
    …direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of ... of procedures for and the effective conduct of the system to review patients' medical charts to ascertain the medical necessity for services and… more
    The County of Los Angeles (09/27/25)
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  • Assistant Director, Institutional Review

    RWJBarnabas Health (Long Branch, NJ)
    …Long Branch, NJReq #:0000197806 Category:Laboratory Status:Full-Time Shift:Day Facility:Monmouth Medical Center Department:Institutional Review Board Pay ... Avenue, Long Branch, NJ 07740 Job Title: Assistant Director Location: Monmouth Medical Center Department: Institutional Review Board Req#: 0000197806 Status:… more
    RWJBarnabas Health (11/18/25)
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