• Sleep Clinical Review Technician

    Hackensack Meridian Health (Edison, NJ)
    …transform healthcare and serve as a leader of positive change. The **Sleep Clinical Review Technician** is responsible for clinical history, signs/symptoms, ... diagnosis code and test order review . Works directly with team members and ordering clinicians and their staff to educate and support appropriate documentation for coding, authorizations and appropriate testing. This position will offer a hybrid schedule.… more
    Hackensack Meridian Health (09/13/25)
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  • Clinical Review Management Liaison…

    St. Luke's Health System (Meridian, ID)
    **Overview** At St. Luke's, our dedicated team of Clinical Review Nurses strive to build a positive, supportive, and inclusive culture that delivers exceptional ... City** _Boise_ **Category** _Nursing - Experienced_ **Work Unit** _Clinical Review Management System Office_ **Position Type** _Full-Time_ **Work Schedule**… more
    St. Luke's Health System (07/19/25)
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  • Director Utilization Management- Clinical

    Texas Health Resources (Arlington, TX)
    Director Utilization Management- Clinical Review _Are you looking for a rewarding career with family-friendly hours and top-notch benefits? We're looking for ... Bachelor's Degree Nursing required Master's Degree preferred Experience 3 years clinical experience in an acute hospital setting required 3 years Utilization… more
    Texas Health Resources (09/25/25)
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  • Sr. Supervisor, Clinical Chart…

    Zelis (St. Petersburg, FL)
    …the personal interests that shape who you are. Position Overview The Sr. Supervisor, Clinical Chart Review is focused on supervising a team of Clinician's ... is responsible for providing team and operational support to the Manager, Clinical Chart Review , Sr. Level Clinicians and Operations Analysts as directed by Sr.… more
    Zelis (09/19/25)
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  • Clinical Denials Coding Review

    HCA Healthcare (Brentwood, TN)
    …HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Denials Coding Review Specialist with Parallon you can be a ... to succeed in our organization. We are looking for an enthusiastic Clinical Denials Coding Review Specialist to help us reach our goals. Unlock your potential!… more
    HCA Healthcare (09/05/25)
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  • Senior Clinical Review Therapist…

    Centene Corporation (Raleigh, NC)
    …to improve the review and execution of therapy services based on clinical reviews of service request. + Assesses and performs utilization reviews of service ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
    Centene Corporation (09/20/25)
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  • Clinical Review Nurse - Prior…

    Centene Corporation (Salem, OR)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
    Centene Corporation (09/28/25)
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  • Clinical Review Specialist II…

    UCLA Health (Santa Monica, CA)
    …for the identification, collection, and entry of quality data for the Clinical Registries, Patient Safety Indicators (PSIs), and Hospital Acquired Conditions (HACs) ... program.This will involve applying your clinical knowledge to analyze data and identify trends and...improvement. You will serve as a liaison between the clinical stakeholders, clinical registries, and outsourced registry… more
    UCLA Health (08/26/25)
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  • Clinical Review Nurse - Concurrent…

    Centene Corporation (Oklahoma City, OK)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
    Centene Corporation (09/27/25)
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  • Clinical Review Clinician - Appeals

    Centene Corporation (Sacramento, CA)
    …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... require CA residency** **Provider appeals exp preferred** **Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical… more
    Centene Corporation (09/28/25)
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