- Evolent (Raleigh, NC)
- …scheduled. + Determines medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all review ... for the mission. Stay for the culture. **What You'll Be Doing:** The Nurse Reviewer is responsible for performing precertification and prior approvals. Tasks… more
- Elevance Health (Durham, NC)
- ** Nurse Reviewer I** A proud member...reviews that are routine having limited or no previous medical review experience requiring guidance by more ... Hours:** **Monday through Friday, 9:30AM - 6PM (CST).** The ** Nurse Reviewer I** is responsible for conducting...+ Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request… more
- Actalent (Charlotte, NC)
- …of Nursing or Bachelor's degree in Nursing. + 2-4 years of related experience in clinical review or prior authorization. + LPN - Licensed Practical Nurse ... Job Title: Medical Authorization Review Specialist Job Description...and cost-effective medical care. Responsibilities + Perform medical necessity and clinical reviews of authorization… more
- UNC Health Care (Hillsborough, NC)
- …at 430 Waterstone Drive, Hillsborough, NC and offers free parking for employees. The Clinical Nurse IV, RN, position is for the 25-bed surgical unit. This ... a community hospital which is an extension of UNC Medical Center focusing on many of our elective surgical...well-being of the unique communities we serve. Summary: The Clinical Nurse IV practices at the level… more
- HCA Healthcare (Asheville, NC)
- …it easier and more affordable to gain certifications and job skills. Apply today for our Clinical Nurse Coord - FT - Night - Adult Med Surg opening and continue ... make a real difference in the lives of adult medical -surgical patients? Look no further than A3 West, our...to learn! **Job Summary and Qualifications** The Clinical Nurse Coordinator (CNC) ensures and delivers… more
- HCA Healthcare (Franklin, NC)
- … Center we support our colleagues in their positions. Join our Team as a Clinical Nurse Coordinator and access programs to assist with every stage of your ... career. **Benefits** Angel Medical Center, offers a total rewards package that supports...gain certifications and job skills. Apply today for our Clinical Nurse Coordinator - FT - Mixed… more
- HCA Healthcare (Asheville, NC)
- …Hospital we support our colleagues in their positions. Join our Team as a Clinical Nurse Coordinator Ortho Trauma and access programs to assist with every ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...gain certifications and job skills. Apply today for our Clinical Nurse Coordinator Ortho Trauma opening and… more
- HCA Healthcare (Asheville, NC)
- …you to apply for our Registered Nurse - FT - Nights - Medical Surgical opening. We review all applications. Qualified candidates will be contacted by ... West Med Surg Unit:** **A7 West is an 18-bed Medical -Surgical unit. We provide care to a diverse mix...nursing journey with us!** **Job Summary and Qualifications** **The Clinical Nurse Coordinator (CNC) ensures and delivers… more
- Fresenius Medical Center (Wadesboro, NC)
- …or federal surveys. + Participates in the completion of the FMS Administrative Clinical Review . **PHYSICAL DEMANDS AND WORKING CONDITIONS:** + The physical ... requirements. Ensure provision of quality patient care while maintaining cost-effective clinical operations in accordance with all legal, compliance, and regulatory… more
- Cognizant (Raleigh, NC)
- …necessity determinations to the Health Plan/ Medical Director based on the review of clinical documentation in accordance with Medicare, Medicaid, and ... as well as timely filing deadlines and processes. . Review clinical denials including but not limited...thinking skills to interpret guidelines of internal policies for clinical determination. . Medical Necessity Reviews can… more