- HCA Healthcare (Houston, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Clinical Reviewer to join our healthcare family. **Benefits** The Woman's ... their passion for patient care. Apply today for our Registered Nurse Clinical Reviewer opportunity. **Job Summary and Qualifications** We are seeking a… more
- Elevance Health (Chicago, IL)
- ** Nurse Reviewer I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in person training sessions, ... integration, and ensures essential face-to-face onboarding and skill development. The ** Nurse Reviewer I** will be responsible for conducting preauthorization,… more
- Elevance Health (Grand Prairie, TX)
- ** Nurse Reviewer I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... integration, and ensures essential face-to-face onboarding and skill development. The ** Nurse Reviewer I** will be responsible for conducting preauthorization,… more
- HCA Healthcare (Conroe, TX)
- …next step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates ... **Introduction** Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your current role? We invest in what… 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
- 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
- CVS Health (Austin, TX)
- …And we do it all with heart, each and every day. **Position Summary** The Clinical Nurse Reviewer will serve as the designated lead for STAR Kids rolling month ... the full oversight, coordination, and execution of the audit process. The nurse will work collaboratively with service coordination teams, quality assurance, and… more
- Veterans Affairs, Veterans Health Administration (Salem, VA)
- Summary The Referral Coordinator Initiative (RCI) Nurse Practitioner is aligned under the Access and Scheduling Management Service and directly reports to the RCI ... Manager. Using the VHA Referral Coordination Initiative Implementation Guidebook, the Nurse Practitioner is responsible for enhancing the quality of clinical… more
- Lee County Board of County Commissioners (Fort Myers, FL)
- Plan Reviewer Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/4918314) Apply Plan Reviewer Salary $31.25 - $45.67 Hourly Location Fort ... Department is seeking a qualified individual to fill the position of Plan Reviewer . The Plan Reviewer will be responsible for reviewing residential and/or… more
- Magellan Health Services (Baton Rouge, LA)
- …engagement, and system-level collaboration with other child-serving agencies. The Clinical Reviewer will support the implementation and ongoing oversight of quality ... + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results...Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt… more