Clinical Reviewer

Job OverviewWe are seeking a skilled Physician Reviewer to join our team at Dane Street. As a key member of our staff, you will utilize your clinical expertise to review insurance appeals and claims, ensuring compliance with client-specific policies and nationally recognized guidelines.ResponsibilitiesReview medical records and address each question posed by...

About the RoleDane Street, LLC seeks highly skilled healthcare professionals to join our team as Physician Reviewers. In this role, you will be responsible for reviewing insurance appeals and claims, utilizing your clinical expertise to interpret the medical necessity of services provided by other healthcare professionals.The ideal candidate will have strong...

Company OverviewMolina Healthcare Services (HCS) works with members, providers, and multidisciplinary teams to assess, facilitate, plan, and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.Job DescriptionThis role assesses inpatient services for members to...

Job OverviewWe are seeking a full-time Clinical Supervisor to join our team at And Still We Rise, LLC, a group mental health practice in Boston, Massachusetts.The successful candidate will be an independently licensed psychotherapist (LICSW, LMFT, or LMHC) with experience in supervising clinical team members. They will provide direct and individual clinical...

Key AccountabilitiesThe successful Physician Reviewer will be responsible for:Interpreting medical necessity and reviewing insurance appeals and claims.Ensuring compliance with client-specific policies and nationally recognized guidelines.Providing clear, concise rationales for determinations, including supporting documentation.Meeting deadlines for case...

About the Opportunity:">We are seeking a highly skilled Clinical Pharmacist Consultant to join our team at Cambia Health Solutions. As a key member of our Pharmacy Services team, you will play a critical role in providing expert clinical guidance and decision-making support to optimize medication choices for efficacy, safety, and affordability.">Your Key...

About the RoleIn this critical position, you will work closely with multidisciplinary teams to promote Molina's Care Model. You will analyze clinical service requests, conduct inpatient reviews, and collaborate with medical directors to ensure optimal outcomes for our members.",

About the RoleMolina Healthcare Services (HCS) is dedicated to providing high-quality care to our members. As a Clinical Care Coordinator, you will play a critical role in assessing, facilitating, planning, and coordinating an integrated delivery of care across the continuum.ResponsibilitiesAnalyze clinical service requests from members or providers against...

Why Work With Us:We are committed to delivering exceptional patient care and providing a supportive work environment for our staff. If you're passionate about animals and dedicated to providing top-notch care, we'd love to hear from you!Job Responsibilities:Assist during exams, outpatient care, and maintain detailed medical recordsReview and implement...

Why Join Us?">We offer a unique opportunity to work as a Physician Reviewer in a dynamic and fast-paced environment. Our team is dedicated to providing high-quality medical reviews and we are seeking a skilled Physician Reviewer to join us.Main ResponsibilitiesReviews all medical records and addresses each question posed by the client utilizing client...

Job OverviewWe are seeking a highly skilled Licensed Psychologist to join our team at MRG Exams. As an Independent Contractor, you will perform medical assessments on United States Veterans as part of the VA's disability benefits process.As a Disability Assessor, your primary responsibility will be to review behavioral health records electronically through a...

Job DescriptionThe Licensed Veterinary Technician will play a crucial role in delivering exceptional care during surgical and dental procedures. Responsibilities include coordinating and executing precise treatment plans, preparing animals for surgery, assisting in the OR, and performing dental procedures.Maintaining detailed surgical records, reviewing and...

Job SummaryThis Physician Reviewer position involves utilizing clinical expertise to review insurance appeals and claims, ensuring compliance with client-specific policies and nationally recognized guidelines. The ideal candidate will have strong analytical skills, attention to detail, and excellent communication abilities.Main ResponsibilitiesConduct...

Job Overview">We are seeking a highly skilled Physician Reviewer to join our team. As a Physician Reviewer, you will utilize your clinical expertise to review insurance appeals, prospective and retrospective claims, and provide an interpretation of the medical necessity of services provided by other healthcare professionals.Main DutiesReviews all medical...

Job DescriptionWe are seeking an experienced Clinical Pharmacist Consultant to join our Pharmacy Services team. As a key member of our team, you will provide expert clinical guidance and decision-making support, evaluating prior authorization requests, appeals, and retrospective claim reviews. You will also contribute to strategic planning and implementation...

Job OverviewAt Dane Street, LLC, we offer a unique opportunity for healthcare professionals to utilize their clinical expertise in reviewing insurance appeals and claims. As a Physician Reviewer, you will play a vital role in interpreting the medical necessity of services provided by other healthcare professionals.This position is ideal for individuals who...

We're looking for a highly skilled Healthcare Consultant to join our team at Dane Street, LLC. As a consultant, you will utilize your clinical expertise to review insurance appeals and claims, ensuring that they meet client-specific policies and nationally recognized evidence-based guidelines.Main Responsibilities:Reviews medical records and addresses each...

Amergis Locum Tenens is seeking a skilled Family Practice/Primary Care Nurse Practitioner to join our team in Bellevue, WA. This is a full-time opportunity to conduct one-time, non-treatment exams related to a Veteran's disability claim.Company OverviewWe are a leading provider of locum tenens services, partnering with the U.S. Department of Veterans Affairs...

Patient Care and SupportAs a Clinical Care Coordinator, you will be responsible for maintaining detailed surgical records, reviewing treatment plans, and addressing client questions regarding their pet's care. You will also work collaboratively with your team to manage orders, coordinate procedures, and maintain an organized and efficient work environment.

We are seeking a highly motivated Quality Specialist to join our team at EvergreenHealth. As a key member of our quality management team, you will be responsible for supporting and facilitating quality management programs and activities aligned with contractual and organizational goals.This is a great opportunity to leverage your expertise in quality...