Clinical Review Nurse

Position Overview:Under the supervision of the Manager of the Utilization Review Program, the Clinical Review Nurse is tasked with ensuring timely and precise evaluation of initial medical necessity assessments throughout the preauthorization and retrospective review processes.Work Environment:This role is designated as remote; however, due to payroll and...

Clinical Review Nurse Job Description Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards contractual requirements and a member's benefit coverage. Provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical...

Position Overview:Under the supervision of the Manager of the Utilization Review Program, the Utilization Review (UR) Nurse plays a crucial role in ensuring the efficient and precise evaluation of initial medical necessity assessments throughout the preauthorization and retrospective review processes.Work Environment:This position is remote; however, due to...

Position Overview:Under the guidance of the Manager of the Utilization Review Program, the Utilization Review (UR) Nurse plays a crucial role in ensuring the efficient and precise management of initial medical necessity evaluations throughout the preauthorization and retrospective review processes.Work Environment:This position is primarily remote; however,...

Position Overview:Under the supervision of the Manager of the Utilization Review Program, the Utilization Review (UR) Nurse plays a crucial role in ensuring the efficient and precise management of initial medical necessity evaluations throughout the preauthorization and retrospective review processes.Work Environment:This position is remote; however, due to...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member...

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member...

About UsNeuropsychiatric Hospitals is a leading healthcare provider with a unique approach to patient care. Our hospitals offer a comprehensive range of services, including neuropsychiatric and complex medical care, to patients with diverse needs.Job SummaryWe are seeking a highly skilled Utilization Review Specialist to join our team. As a Utilization...

About UsNeuroPsychiatric Hospitals is a leading healthcare provider with a unique approach to patient care. Our hospitals offer a comprehensive range of services, including neuropsychiatric and complex medical care, to patients with diverse needs.Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team. As a key member of...

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD) and Immunology/Infusion Care With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire...

Job SummaryAxiom Care is a rapidly growing healthcare organization providing substance abuse treatment and sober living housing services. We serve low-income and justice-involved individuals seeking to change their lives for the better. Our comprehensive approach includes medical services, evidence-based counseling, case management, housing assistance, and...

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!!We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only) Job Summary Conducts retrospective review of behavioral health or medical/surgical claims for...

Position OverviewCommonSpirit Health is dedicated to providing exceptional healthcare services, and we are seeking a skilled Clinical Research Nurse to enhance our Neurosurgery Clinical Research Team. This role is pivotal in managing and coordinating various clinical protocols, ensuring adherence to regulatory standards and promoting the advancement of...

Job OverviewAt Valenz Health, we streamline the intricacies of self-insurance for employers, emphasizing our unwavering dedication to data transparency and decision-making support through our Healthcare Ecosystem Optimization Platform. Our robust foundation is built on extensive experience in clinical and member advocacy, alongside years of expertise in...

Job SummaryThe Clinical Nurse Specialist at Phoenix Children's is responsible for delivering professional nursing care in a transport and critical care environment. This role requires collaboration with the healthcare team, patient, and family to provide care that is appropriate to the patient's age and condition.Key ResponsibilitiesConduct thorough nursing...

Job Description Clinical Research Nurse Clinical Research Nurse  Apply!  Apply! Position DetailsDepartment: RSRCH-GRNT | Nephrology Research StudiesCategory: ResearchLocation: PhoenixEmployee Type: RegularPosting #: 863321Posted On: 7/19/2024 Position Summary This position provides and coordinates clinical care for research subjects. This position has a...

Position OverviewWelcome to UnavailableAt Unavailable, we are committed to providing exceptional healthcare services. Our organization is recognized for its dedication to quality patient care and innovative medical research. We pride ourselves on our mission to serve diverse communities and improve health outcomes.We are currently seeking a Clinical Research...

Position Overview Role: Clinical Research Nurse Department: RSRCH-GRNT | Nephrology Research Studies This role is pivotal in delivering and managing clinical care for participants involved in research studies. The Clinical Research Nurse is responsible for ensuring the safety of participants, maintaining informed consent, and upholding the integrity of...

Job DescriptionJob DescriptionValenz® Health simplifies the complexities of self-insurance for employers through a steadfast commitment to data transparency and decision enablement powered by its Healthcare Ecosystem Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim...

Position Overview Clinical Research Nurse This role is pivotal in delivering and managing clinical care for participants involved in research initiatives. The Clinical Research Nurse ensures the safety of participants, upholds informed consent, and guarantees the integrity of protocol execution, as well as the precision of data collection and follow-up. Key...