- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review Work Environment + This is a 100% remote position + The schedule is Tuesday to Saturday, 10 AM to 7 ... review , case management, and concurrent review . Job Description The Clinical Review Nurse will perform concurrent reviews to assess the member's… more
- Children's Mercy Kansas City (Kansas City, MO)
- …can improve the lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, ... from admission through hospital stay to discharge. Adeptly uses evidence based clinical practice guidelines to determine the appropriate level of care and the… more
- Actalent (Tigard, OR)
- Job Title: Clinical Review Nurse - Concurrent Review (West Coast) Job Description We are seeking a dedicated Clinical Review Nurse to perform ... with at least 2 years in acute care. + Strong skills in clinical review , utilization management, and concurrent review . + Self-starter with excellent time… more
- Elevance Health (Louisville, KY)
- ** Clinical Review Nurse I** **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training ... for Medicare and Medicaid Services to transform federal health programs. The ** Clinical Review Nurse ** is responsible for reviewing and making medical… more
- Actalent (Bakersfield, CA)
- Remote Concurrent Review Nurse Job Description We are seeking a dedicated Concurrent Review Nurse to perform concurrent reviews, assess members' overall ... interdepartmental teams on projects within utilization management as part of the clinical review team + Partners and works with Medical Affairs and/or Medical… more
- Centene Corporation (Sacramento, CA)
- …with interdepartmental teams on projects within utilization management as part of the clinical review team + Partners and works with Medical Affairs and/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,… more
- Centene Corporation (New York, NY)
- …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, ... and cost effectiveness of medical care. + Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in… more
- Centene Corporation (Olympia, WA)
- …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
- Catholic Health (Buffalo, NY)
- … to patients and families in the hospital setting. Utilizing foundational nursing clinical skills Utilization Review nurse collaborates with the ... Days with Weekend and Holiday Rotation Hours: 8:00am to 4:00pm Summary: The Registered Nurse (RN), Utilization Review , as an active member of the Middle Revenue… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Nurse is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with healthcare standards and ... regulations. This role involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement initiatives to enhance patient… more
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