- Abbott (Kansas City, MO)
- …, with a schedule of **Monday-Friday, 8:00 AM - 5:00 PM** . The position of Clinical Review Nurse is within our Toxicology division located at our **Kansas ... City, MO** site within Workplace Solutions. In this role, the ** Clinical Review Nurse ** is responsible for accuracy and integrity of the Workplace Solutions… more
- Baystate Health (Springfield, MA)
- …Minimum - Midpoint - Maximum $87,859.00 - $100,984.00 - $119,412.00 **UM Outpatient Clinical Review Nurse - Baystate Health, Health New England** **This ... opportunity** **.** **Current States Eligible MA and CT** The **UM Outpatient Clinical Review Nurse ** contributes to the overall success of the Utilization… more
- Actalent (St. Louis, MO)
- Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full‑Time About the Role We ... are seeking an experienced Registered Nurse to join our team within a leading Managed...This role is fully remote and focuses on reviewing clinical documentation to determine medical necessity, appropriateness of care,… more
- Centene Corporation (Jefferson City, MO)
- …administered with quality, cost efficiency, and are within compliance. + Performs a clinical review of post-care services by reviewing medical records against ... a fresh perspective on workplace flexibility. **Position Purpose:** Performs a clinical retrospective review of services previously provided to determine… more
- Centene Corporation (Denver, CO)
- …management to identify and implement opportunities for improvement. + Oversees the clinical review of outcomes including creating and editing correspondence ... State, and NCQA standards + Provides expert insight and guidance on the clinical review process of correspondence to ensure compliance with all applicable… more
- 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, ... discuss member care being delivered + Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in… more
- Evolent (Lansing, MI)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... physician-developed medical policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as a member advocate, expediting care… more
- System One (Baltimore, MD)
- Job Title: Clinical Medical Review Nurse Location: Baltimore, MD 21224 Type: Contract, 5 mos with chance of extension Compensation: Based on experience ... plus occassional travel to providers for record retrieval, as needed. Clinical Medical Review Nurse / Medical Records Abstraction Specialist Schedule: 8-hour… more
- Baystate Health (Springfield, MA)
- …Education/Experience:** + Massachusetts RN license required + 3-5 years' experience as a UM Clinical Review Nurse for a Health Plan + Understanding of ... - Maximum $96,137.00 - $110,510.00 - $130,728.00 **UM Regulatory Nurse Specialist - Baystate Health, Health New England** This...This position will also manage all requirements around coding review for the department. This position works to ensure… more
- Elara Caring (Harker Heights, TX)
- …the Right Care, at the Right Time, in the Right Place. **Job Description:** Clinical Team Specialist/Oasis Review Nurse Specialist At Elara Caring, we ... have countless ways to make a difference as a Clinical Team Specialist by providing quality care. Being a...+ 2 years home care experience as a registered nurse in a Home Health or Hospice environment +… more
Related Job Searches:
Clinical,
Clinical Nurse,
Clinical Review,
Clinical Review Nurse Concurrent,
Clinical Review Nurse Prior,
Nurse,
Registered Nurse Clinical Review,
Review,
Review Nurse,
Senior Clinical Review Nurse