- Geisinger (Lewistown, PA)
- Job Summary The Pharmacist provides quality pharmaceutical care defined as being responsible for assuring the provision of safe, efficacious and cost-effective ... patients. The Pharmacist will develop, recommend, and monitor evidence based pharmacotherapy care plans for patients cared for by Geisinger with emphasis on patient… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- … Clinical Responsibilities (50% of the time) Performs an average of 32 hours of direct clinical care per pay period The Tele Emergency Care Director ... provided Leading or participating in staff meetings, peer review processes, budgetary presentations, as may be assigned or...urgent care setting Covering extended hours of clinical care , including during evenings, nights, holidays… more
- Providence (Santa Rosa, CA)
- …382655 **Company:** Providence Jobs **Job Category:** Care Management **Job Function:** Clinical Care **Job Schedule:** Per -Diem **Job Shift:** Day ... **Description** Care Manager RN - Case Management at Providence...Memorial Hospital in Santa Rosa, CA. This position is Per Diem and will work 8-hour Day shifts. Providence… 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
- BJC HealthCare (St. Louis, MO)
- …relevant work experience) **Additional Information About the Role** BJC is hiring for a Surgical/ Clinical Reviewer . This is a remote position. Must be located in ... medical schools in the country. **Preferred Qualifications** **Role Purpose** The Surgical Clinical Reviewer (SCR) is responsible for abstracting and sharing… more
- Magellan Health Services (Somerset, PA)
- …Project management skills and demonstrated experience. General Job Information Title Quality Clinical Reviewer - Somerset-Bedford, PA Grade 25 Work Experience - ... reporting. Interacts with multiple stakeholders internally and externally. Provides clinical reviews of Quality of Care (QOC)...of patient safety risk and need for follow-up actions per policies. + Collects, analyzes and prepares clinical… more
- AmeriHealth Caritas (Lafayette, LA)
- …and providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer 's discretion to retain ... and recognize care coordination opportunities and refer those cases to integrated care management as needed. The BH UM Reviewer will apply medical health… more
- AdventHealth (Altamonte Springs, FL)
- …support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient. The Second Level Reviewer I educates members of ... team regarding documentation guidelines, including physicians, allied health practitioners, nursing, and care management. The Second Level Reviewer I adheres to… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …and other services within scope of practice per business needs. The reviewer will ensure services align with established clinical guidelines and policies. ... is part of a larger team and works independently and collaboratively to facilitate care using clinical skills, principles of managed care , nationally… more
- Elevance Health (Mason, OH)
- **Nurse Reviewer I** **Location:** **Virtual:** This role enables associates to work virtually full-time, with the exception of required inperson training sessions, ... and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable… more