• Pharmacy Clinical Review

    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 ... provides customer service to Rx Partners Skilled nursing and Hospice clients. The clinical review specialist at Rx Partners works hand in hand with a… more
    UPMC (10/30/25)
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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 ... and 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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  • RN Clinical Review Appeals…

    St. Luke's University Health Network (Allentown, PA)
    …serve, regardless of a patient's ability to pay for health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, ... 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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  • 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 ... caring group of colleagues. Do you want to work as a Clinical Denial Coding Review Specialist where your passion for creating positive patient interactions… more
    HCA Healthcare (11/26/25)
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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 (11/25/25)
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  • Clinical Documentation Integrity…

    Avera (Sioux Falls, SD)
    …teams with non- clinical tasks. By handling essential administrative responsibilities, the Specialist enables clinical staff to concentrate on work requiring ... daily administrative tasks to facilitate collection, organization and distribution of clinical documentation to support CDI/UR workflows. + Clinical Denial… more
    Avera (11/27/25)
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  • Clinical Rehab Specialist PRN

    HCA Healthcare (Dallas, TX)
    …who may need acute inpatient rehabilitation services prior to returning home. The Clinical Rehabilitation Specialist will review these patients daily until ... encourage you to apply for our Clinical Rehab Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for… more
    HCA Healthcare (09/27/25)
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  • Healthcare Clinical Documentation…

    Deloitte (Chicago, IL)
    …as clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk… more
    Deloitte (11/21/25)
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  • Clinical Revenue Specialist - Case…

    Montrose Memorial Hospital (Montrose, CO)
    …care provided. This position combines the unique skill sets of the Utilization Review Nurse and Clinical Documentation Specialist to facilitate documentation ... patient. About The Career: + The purpose of the Clinical Revenue Specialist position is to ensure...preferred; and one (1) to two (2) years Utilization Review experience preferred. What We Offer: + Mentoring +… more
    Montrose Memorial Hospital (11/19/25)
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  • Utilization Review Coordinator

    Community Health Systems (Franklin, TN)
    …secure timely authorizations and reduce potential denials, utilizing input from the Utilization Review Clinical Specialist . + Monitors and updates case ... **Job Summary** The Utilization Review Coordinator ensures efficient and effective management of...activities. This role collaborates with payers, hospital staff, and clinical specialists to secure timely authorizations for hospital admissions… more
    Community Health Systems (11/22/25)
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