• VitalCore Health Strategies (Hopkinton, MA)
    …The Psychologist will performing clinically sound suicide risk evaluations, including clinical review , applying suicide risk assessment protocols, pertinent ... health assessments, provide therapy and counseling, administrative meetings, writing clinical reports regarding diagnoses, prognoses, and developing treatment plans… more
    Get It 2025 (11/25/25)
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  • VitalCore Health Strategies (Smyrna, DE)
    …and paraprofessional staff. * Ensure and provide on-call services. * Annually review and approve clinical protocols, policies and procedures, and medical ... health authority required by national standards. They provide overall supervision for clinical services for the site to ensure appropriate delivery of on and… more
    Get It 2025 (11/25/25)
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  • VitalCore Health Strategies (Hopkinton, MA)
    …* Utilization Management experience. * Must have minimum of 5 years clinical experience in Family Practice, Emergency Medicine, Internal Medicine, Public Health, or ... care in a region. * Serve as liaison for clinical matters related to on-site, off-site specialty care, emergency...and assistance to the on-site quality improvement program, including review of grievances and development of corrective action plans… more
    Get It 2025 (11/25/25)
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  • ColumbiaCare Services (Eugene, OR)
    …performing housekeeping and meal preparation, administering medication, and keeping accurate clinical documentation. If you have experience working as a Qualified ... Bridge program serves 8 adults under the jurisdiction of the Psychiatric Security Review Board (PSRB), and another 8 adults that are under civil commitment.… more
    Get It 2025 (11/25/25)
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  • RN Clinical Review Appeals…

    St. Luke's University Health Network (Allentown, PA)
    …regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data ... DUTIES AND RESPONSIBILITIES: + Conduct retrospective medical record reviews for clinical validation of diagnosis and procedure code assignment and MS-DRG/APR-DRG… more
    St. Luke's University Health Network (10/28/25)
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  • Pharmacy Clinical Review Specialist,…

    UPMC (Bridgeville, PA)
    UPMC Rx Partners is looking for a full time Pharmacy Clinical Review Specialist to join their dedicated team! This position provides prescription data entry and ... provides customer service to Rx Partners Skilled nursing and Hospice clients. The clinical review specialist at Rx Partners works hand in hand with a licensed… more
    UPMC (10/30/25)
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  • 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 Utilization Review

    Community Health Systems (Franklin, TN)
    **Job Summary** The Clinical Utilization Review Specialist is responsible for evaluating the necessity, appropriateness, and efficiency of hospital services to ... collaborates with healthcare providers to facilitate efficient patient care. The Clinical Utilization Review Specialist monitors adherence to hospital… more
    Community Health Systems (11/15/25)
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  • Manager, Clinical Data Review

    Abbott (Maple Grove, MN)
    …diabetes from routine fingersticks. **The Opportunity** We are looking for our next **Manager, Clinical Data Review ** to lead our team on-site out of our Maple ... execute processes; continually evaluate their effectiveness and appropriateness. The Manager, Clinical Data Review will exercise judgment in planning, organizing… more
    Abbott (10/22/25)
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  • Clinical Denial Coding Review

    HCA Healthcare (Plano, TX)
    **Description** **Introduction** Do you have the career opportunities as a Clinical Denial Coding Review Specialist you want with your current employer? We have ... caring group of colleagues. Do you want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive patient interactions is… more
    HCA Healthcare (11/26/25)
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