Clinical Nurse Reviewer

Clinical Reviewer Job DescriptionAs a Clinical Reviewer at IPRO, you will play a crucial role in ensuring the accuracy and appropriateness of healthcare services. Your expertise will be utilized to conduct clinical-level reviews, supporting Medical Review Analysts and Physician Consultants in their decision-making processes.Key Responsibilities:Conduct...

Clinical Reviewer Job DescriptionIPRO is seeking a skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will play a critical role in ensuring the accuracy and quality of our review processes.Key Responsibilities:Conduct thorough reviews of medical records to ensure compliance with regulatory requirements.Utilize expertise in electronic...

Job Title: Maternal Nurse ReviewerWe are seeking a skilled Maternal Nurse Reviewer to join our team at Greenlife Healthcare Staffing. As a Maternal Nurse Reviewer, you will be responsible for conducting clinical reviews of medical records and providing technical assistance to program personnel.Responsibilities:Conduct clinical reviews of medical records from...

Job Title: Maternal Nurse ReviewerWe are seeking a skilled Maternal Nurse Reviewer to join our team at Greenlife Healthcare Staffing. As a Maternal Nurse Reviewer, you will be responsible for conducting clinical reviews of medical records and providing technical assistance to program personnel.Responsibilities:Conduct clinical reviews of medical records from...

Job Summary:Acentra Health is seeking a skilled Nurse Clinical Reviewer to join our team. As a key member of our team, you will utilize your clinical expertise to review medical records against established criteria, ensuring the delivery of high-quality healthcare services.Responsibilities:Review and interpret patient records to determine medical necessity...

Job SummaryWe are seeking a skilled Clinical Review Nurse to join our team at MedNational Staffing Inc. This role involves conducting thorough clinical reviews of UM standard, expedited Inpatient, Outpatient, and Custodial Care requests for MLTC members.Key ResponsibilitiesConduct clinical reviews of UM standard, expedited Inpatient, Outpatient, and...

Job SummaryWe are seeking a highly skilled Clinical Review Nurse to join our Medical Management/Health Services team. As a clinical professional, you will play a critical role in determining the medical appropriateness of care for our 28 million members.Key ResponsibilitiesPerform medical necessity and clinical reviews of authorization requests to ensure...

Job Title: RN - Clinic Utilization ReviewVNS Health is seeking a skilled Registered Nurse (RN) to join our team in Clinic Utilization Review in New York. As a key member of our team, you will play a crucial role in resolving grievances, appeals, and external reviews for VNS Health Plans product lines.Key Responsibilities:Ensure regulatory compliance and...

Job Title: Clinical Review SpecialistUS Tech Solutions is seeking a skilled Clinical Review Specialist to join our team. As a Clinical Review Specialist, you will be responsible for reviewing and evaluating clinical information and documentation to ensure compliance with regulatory and accreditation guidelines.Key Responsibilities:Review and evaluate...

Job SummaryAlbany Medical Center is seeking a skilled Clinical Utilization Review Specialist to join our team. As a key member of our Care Management department, you will be responsible for ensuring the efficient and effective use of healthcare resources.Key ResponsibilitiesConduct thorough reviews of patient records to identify opportunities for improvement...

Job SummaryThe University of New Mexico - Hospitals seeks a skilled Clinical Case Reviewer to support the Professional Practice Committee (PPC) in the management of data and information for ongoing professional practice evaluation (OPPE) and focused professional practice evaluation (FPPE). This role involves monitoring, validating, and documenting aggregate...

Job SummaryAlbany Medical Center is seeking a skilled Clinical Utilization Review Specialist to join our team. As a key member of our Care Management department, you will play a critical role in ensuring the quality and efficiency of patient care.Key ResponsibilitiesConduct thorough utilization reviews to identify opportunities for improvement in patient...

Job Description:We are seeking a highly skilled Clinical Review Specialist to join our team at US Tech Solutions.The successful candidate will be responsible for reviewing and evaluating clinical information and documentation to ensure compliance with regulatory and accreditation guidelines.Key Responsibilities:Review and interpret clinical records and data...

Job SummaryVNS Health is seeking a skilled Registered Nurse to join our team as a Clinical Utilization Review Specialist. In this role, you will be responsible for resolving grievances, appeals, and external reviews for our Managed Long Term Care, Medicare Advantage, and Select Health product lines.Key Responsibilities:Investigate and review routine and...

Job SummaryWe are seeking a highly skilled Clinical Utilization Review Specialist to join our team at Albany Medical Center. As a key member of our Care Management department, you will play a critical role in ensuring the quality and efficiency of patient care.Key ResponsibilitiesConduct thorough utilization reviews to identify opportunities for improvement...

Clinical Review Opportunities at Dane Street **About the Role** Dane Street is seeking skilled healthcare professionals to conduct comprehensive clinical reviews. As a Clinical Review Specialist, you will play a critical role in evaluating medical cases and providing expert opinions. **Key Responsibilities** * Conduct thorough clinical reviews of medical...

Job Title: Clinical Nurse SpecialistNorthwell Health is seeking a highly skilled Clinical Nurse Specialist to join our team. As a Clinical Nurse Specialist, you will be responsible for providing expert nursing care to patients with complex medical needs. You will work closely with our interdisciplinary team to develop and implement individualized care plans...

Clinical Review Opportunities at Dane Street **About the Role** Dane Street is seeking skilled healthcare professionals to conduct thorough clinical reviews of Group Health cases. As a Clinical Review Specialist, you will play a critical role in providing expert opinions on medical treatments and services. **Key Responsibilities** * Conduct comprehensive...

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our Care Management team at Albany Medical Center. As a key member of our team, you will be responsible for ensuring the efficient and effective use of healthcare resources while maintaining high-quality patient care.Key ResponsibilitiesConduct thorough utilization reviews to identify...

Job Title: Clinical Registered Nurse - Contract - Nassau CountyNorthwell Health is seeking a skilled Clinical Registered Nurse to join our team in Nassau County. As a Clinical Registered Nurse, you will be responsible for providing high-quality patient care and collaborating with our interdisciplinary team to achieve optimal patient outcomes.Job Summary:The...