- HCA Healthcare (Austin, TX)
- …to the Maternal Program Manager using facility approved audit tools. As the NICU Clinical Nurse Reviewer , . You will review patient's medical record and ... apart from any other healthcare provider. We are seeking a(an) Clinical Nurse Reviewer Neonatal ICU to join our healthcare family. **Benefits** St. David's North… more
- Elevance Health (Indianapolis, IN)
- ** Nurse Reviewer I** **Virtual:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing ... rotating weekends.** **New Grads are encouraged to apply!** The ** Nurse Reviewer I** will be responsible for...that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or… more
- Commonwealth Care Alliance (Boston, MA)
- …clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA ... Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible for day-to-day… more
- Chenega Corporation (Rockville, MD)
- …**Chenega Professional Services Strategic Business Unit** company, is looking for a Nurse Practitioner-Contract Medical Reviewer (CMR) to support the Department ... closely with the Government and Contractor team trainers, physicians, and nurse practitioners. + Support management, administration, data, communication, and other… more
- Evolent (Olympia, WA)
- …mission. Stay for the culture. **What You'll Be Doing:** The Nurse Practitioner/Physician Assistant (ARNP/NP/PA) Cardiology is responsible for support and assistance ... with the Director of UM to ensure client satisfaction. Perform all peer clinical review activities while located in a state or territory of the United States. Acts… more
- AmeriHealth Caritas (Lafayette, LA)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines ... Demonstrated ability to meet productivity standards in a fast-paced, high-volume utilization review environment. **Licensure:** + An active Registered Nurse (RN)… more
- AmeriHealth Caritas (Washington, DC)
- …When necessary, cases are escalated to the Medical Director for further review . The reviewer independently applies medical and behavioral health guidelines ... on clinical criteria. Using professional judgment, the Clinical Care Reviewer assesses the appropriateness of services, identifies care coordination opportunities,… more
- Hartford HealthCare (Hartford, CT)
- …The primary responsibility of the Metabolic and Bariatric Surgical/Medical Clinical Reviewer (MBSCR) is to ensure the accurate and timely collection, documentation, ... registry activities, including program teleconferences and meetings. Maintains Surgical Clinical Reviewer (SCR) certification on an annual basis, in accordance with… more
- Adecco US, Inc. (Minneapolis, MN)
- …days **Pay:** $40.50 to $42.50 an hour **Responsibilities of the RN Appeals Reviewer :** . Responsible for conducting thorough reviews of member and provider appeals, ... when appropriate. . You will summarize medical information for review by the Medical Director as needed, ensuring a...and meeting production goals. **Qualifications for the RN Appeals Reviewer :** . Associates degree . Active and good standing… more
- St. Luke's University Health Network (Bethlehem, PA)
- …regardless of a patient's ability to pay for health care. The Admission's Clinical Reviewer is responsible for the comprehensive medical review and screening of ... and responds to all inquiries for admission to ARC + Completes thorough review of documentation and information and assesses a patient's appropriateness for ARC… more
Related Job Searches:
Clinical Reviewer Nurse,
New Admissions Nurse Reviewer,
Nurse,
Nurse Reviewer AIM,
Nurse Reviewer Quality Assurance,
Nurse Reviewer RN,
Nurse Reviewer US,
Nurse Utilization Management Reviewer,
Reviewer,
Surgical Clinical Nurse Reviewer