- Evolent (Pierre, SD)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse , you will routinely interact with...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Evolent (Annapolis, MD)
- …Join a mission with a company behind it. **What You'll Be Doing:** As a Clinical Reviewer , Nurse , you will be a key member of the utilization management team. We ... providing better health outcomes. **Collaboration Opportunities:** As a Clinical Reviewer , Nurse , you will routinely interact with...You Will Be Doing:** + Functions in a clinical review capacity to evaluate all cases, which do not… more
- Elevance Health (San Juan, PR)
- …providing information technology and business operations services for health plans._ ** Nurse Reviewer I** **Location:** This role requires associates to ... but must be flexible according to business needs. The ** Nurse Reviewer I** is responsible for conducting...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial medical necessity review … more
- City of New York (New York, NY)
- …health standards for children in foster care. The New Admissions Focused (NAF) Nurse Reviewer will be responsible for: 1. Scheduling and conducting NAF ... 5 boroughs 2. Participating in all post medical record review quality monitoring and corrective action processes 3. Conducting...subject of a child abuse and maltreatment report. STAFF NURSE - 50910 Qualifications 1. A valid New York… more
- Evolent (Nashville, TN)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks ... cost effective care delivery. **What You'll Be Doing:** + Performs utilization review of outpatient procedures and ancillary services. + Fulfills on call… more
- Commonwealth of Pennsylvania (PA)
- Clinical Care Reviewer (County Care Management Manager) (Local Government) - Fayette County MH/ID Print ... (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/4995788) Apply Clinical Care Reviewer (County Care Management Manager) (Local Government) - Fayette… more
- Catholic Health (Buffalo, NY)
- …EDUCATION + Graduate of an accredited School of Nursing + Bachelor of Science in Nursing (BSN) preferred + Current New York State RN license + Valid drivers license ... Salary: 67,606.50-101,419.50 USD Facility: Administrative Regional Training Cntr Shift: Shift 1 Status: Full Time FTE: 1.000000 Bargaining Unit: ACE Associates Exempt from Overtime: Exempt: Yes Work Schedule: Days Hours: 8:00am-4:00pm Summary: Conducts audits… more
- AdventHealth (Orlando, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...(ROM), and quality. + Completes accurate and timely record review to ensure the integrity of documentation compliance. +… more
- AdventHealth (Altamonte Springs, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...(ROM), and quality. . Completes accurate and timely record review to ensure the integrity of documentation compliance. .… more
- Elevance Health (Seven Hills, OH)
- **Case Reviewer (NP/PA)** **Carelon Medical Benefit Management** **Orthopedic Surgery** **Virtual:** This role enables associates to work virtually full-time, with ... unless an accommodation is granted as required by law._ The **Case Reviewer ** is responsible for conducting pre-authorization, out of network and appropriateness of… more
Related Job Searches:
Clinical Nurse Reviewer,
Clinical Reviewer Nurse Cardiac,
Clinical Reviewer Nurse Pain,
Clinical Reviewer Nurse Surgery,
Nurse,
Nurse Reviewer AIM,
Registered Nurse Clinical Reviewer,
Reviewer,
Surgical Case Nurse Reviewer,
Utilization Management Nurse Reviewer