Average salary: $78,799 /yearly
More stats ...therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science... ...project-specific training and coaching of team members and review of team output cross-functionally.
- Effectively represent...
Medical
...Nurse Reviewer I
Description
Nurse Reviewer I
Location: Within 50 miles of a pulse point
Shift : Monday - Friday, from 9:30 am - 6... ...Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior...
Medical
Holiday work
Temporary work
Work experience placement
Local area
Remote job
Shift work
Monday to Friday
...be considered*
Position Summary
It's an exciting time for our Medical Economics team at CVS Health. As a growing team in a Fortune 5... ...priorities and multiple projects. As part of the Medical Expense Review (MER) team, you will prepare for monthly presentations, and...
Medical
Hourly pay
Holiday work
Full time
Temporary work
Work experience placement
Local area
Flexible hours
...and each other.
POSITION TITLE
Claims Clinical Specialist – Medical Review Team
POSITION LOCATION
This position is available to... ...Specialist role is an excellent opportunity for a Registered Nurse seeking a career change. Bring your nursing knowledge and experience...
Medical
Holiday work
Permanent employment
Temporary work
Local area
Remote job
...based on Departmental standards.
• While performing utilization review identifies areas for clinical documentation improvement and... ...continuous improvement in both areas.
• Refers cases and issues to Medical Director and Triad Team in compliance with Department...
Medical
Shift work
...Utilization Review Nurse
Per Diem
1648 Huntingdon Pike
Nursing RN/LPN
Day
SUMMARY OF JOB:
To review each admission for appropriate assignment of level of care based upon clinical guidelines as well as to review documentation for continued stays daily and provide...
Suggested
...hybrid, allowing for remote work at times and requiring an onsite presence at Central Vermont Medical Center in Berlin, VT.
POSITION SUMMARY
The Utilization Review Nurse is responsible for ensuring the medical necessity and appropriate level of care of all hospital...
Medical
Remote job
...care for the sick and injured; educate physicians, nurses and other health care providers; and improve... ...ability to pay for health care.
The Utilization Review Nurse will be responsible for substantiating medical necessity and clinical appropriateness of services...
Medical
Under general supervision of the Director of Case Management, the Utilization Review Nurse provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services. Provides feedback and assistance...
Medical
Permanent employment
Temporary work
...Work
Work Shift:
Day (United States of America)
Utilization Review Nurse
Salary Range: $31.28 - $51.61 per hour
Responsible for... ...continuous improvement in both areas.
Refers cases and issues to Medical Director and Triad Team in compliance with Department...
Medical
Hourly pay
Permanent employment
Shift work
...Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your current role? We invest in what matters most... ...The available plans and programs include:
Comprehensive medical coverage that covers many common services at no cost or for...
Medical
Permanent employment
Full time
Temporary work
Part time
Flexible hours
Position Title: Surgical Case Nurse Reviewer
Company: ACT1 Federal
Location: Eglin, AFB, Florida
About ACT1 Federal: Delivering mission... ...Case Nurse Reviewer (SCNR) to support our customer at the Medical Treatment Facility (MTF) at Eglin Air Force Base (AFB). You...
Medical
Holiday work
Permanent employment
Temporary work
Flexible hours
...Utilization Review RN - As Needed - Days
Under general supervision, utilize clinical... ...screening software to identify appropriate medical necessity, length of stay, and level of... ...guidelines.
Education:
Bachelor of Science in Nursing (BSN) OR Advanced Practitioner licensure...
Medical
Local area
...self-pay patients.
ESSENTIAL DUTIES AND RESPPONSIBILITIES:
Review claims submissions for accuracy by confirming proper payer,... ...Proficiency using Microsoft Excel
Thorough knowledge of medical insurance terminology and payer explanation of benefits and experience...
Medical
Full time
...Title: Medical Review Coordinator Department: Pension
FLSA: Non-exempt Hours: 40
Union: UFCW 1546 Grade: 23
Date Posted: 02/28/2024
Position Summary
The Medical Review coordinator ensures documentation needed for medical review is complete and accurate...
Medical
Local area
$18 - $19 per hour
...MUST HAVE Knowledge of CPT, ICD-9/10 and HCPCS codes along with commonly used concepts and practices in Workers Compensation medical bill review/auditing . Prepares and compiles medical provider bill data for Workers Compensation clients.
The successful candidate...
Medical
Full time
$18 - $20 per hour
...Job Summary:
The Handicap Coordinator will review workers' compensation claims/medical records to identify pre-existing conditions that may have delayed recovery. Gather all supporting medical documentation and submit with necessary forms/applications to the Ohio Bureau...
Medical
Holiday work
Full time
Temporary work
Immediate start
...JOB DESCRIPTION
Job Title: MEDICAL DATA ENTRY/DOCUMENTATION REVIEWER
JOB SUMMARY
Sunstar Paramedics is seeking a medical data entry / document reviewer to work in our patient billing services department. This position is responsible for auditing EMS transport documentation...
Medical
...The Medical Records Review Specialist will play a crucial role in ensuring the accuracy and completeness of our electronic medical record system... ....
Education and Experience:
Bachelor's degree in Nursing, Healthcare Administration, or related field (for Nurse...
Medical
Full time
Local area
Immediate start
...Job Title: Physician Reviewer
Location: 100% Remote
Duration: 2-year contract
Remote in our five states in NM, TX, IL, OK, MT
Schedule:
Must be available M-F for full-time training to start.
This position prefers a 2 week full...
Holiday work
Full time
Contract work
Remote job
Weekend work
Weekday work
...Shift
**Description:**
General Summary:
The Clinical Concurrent Reviewer position exists to support Quality and Performance Improvement... ...and compliance requirements;
o Providing concurrent medical record review to assess documentation compliance and facilitating...
Medical
Full time
Shift work
Day shift
Summary:
In a High Reliability Organization, the Peer Review Nurse, reporting to the Director of Quality, is responsible for organizing and coordinating Medical Staff Peer Review activities of hospital. This individual, as a designee of the Chief Medical Officers, will...
Medical
Permanent employment
Full time
....
GENERAL SUMMARY:
The Utilization Review RN monitors, collects and analyzes data and... ...RN in utilizing these skills assists the Medical Center in providing optimal care in a... ...:
1. Current New York State Registered Nurse license required.
2. CCM Preferred. Utilization...
Medical
...responsibility.
Role Overview :
This role manages the Medical Review Team, collaborating to make determinations regarding the... ...contactors that include physicians, phycologists, and registered nurses.
The ideal candidate will have a Bachelors Degree plus a minimum...
Medical
Holiday work
Full time
Temporary work
Traineeship
Work experience placement
Remote job
Flexible hours
...A client of ours is searching for temporary document review attorneys for a 4 month project. This role will require 2 days on-site in... ...communication skills
Pay Rate: $30/hour
Benefit offerings include medical, dental, vision, life insurance, short-term disability,...
Medical
Hourly pay
Holiday work
Temporary work
For contractors
Local area
Overview
The LPN Medication Care Manager is responsible for providing the highest degree of... ...in a safe organized manner.
• Reviews, reads, notates, and initializes Daily Log... ...Resident Care Director (RCD) or Wellness Nurse.
• Administers, assists with, and observes...
Local area
Immediate start
Shift work
...bonuses, overtime, shift differential, etc.)****
Utilization Reviewer
Pathway Family Services, LLC. provides resources for youth... ...care services.
Qualifications:
Bachelor's degree in nursing, social work, psychology, or a related field.
A minimum of...
Hourly pay
Local area
Flexible hours
Shift work
...clinical trial data and participates in applicable safety surveillance activities for assigned studies including review of labs, vital signs, cardiac, medications, medical history, and can communicate with Study Lead any findings.
• Provide review of safety-related data...
Medical
Remote job
Contract work
...Wilmington, Delaware, United States
Clinical Operations Medical Director
Utilization Management of Medical Oncology... ...providers.
Job Summary:
+ Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive care....
Medical
Work experience placement
Local area
Remote job
Work from home
Relocation bonus
Flood Review is responsible for ensuring sufficient flood insurance coverage and regulatory timing requirements on all loans closed or purchased where the property is in a flood zone. This is a regulatory requirement. The team handles complex and time sensitive flood issues...