Clinical Review Nurse

Job Summary:We are seeking a skilled Clinical Review Specialist to join our team at Elite PC Services. As a key member of our utilization review team, you will be responsible for evaluating medical necessity and determining the appropriateness of treatments in Workers' Compensation cases.About the Role:Evaluate medical data and treatment requests to...

Job SummaryRelying on your clinical background, you will review health claims, providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals. You will be working in compliance with Concentra Physician Review policies, procedures, and performance standards as well as URAAC guidelines and state...

Key Responsibilities:Conduct thorough medical reviews, analyzing patient data and medical records.Collaborate with healthcare professionals to ensure accurate and efficient claim processing.Maintain up-to-date knowledge of medical guidelines, policies, and procedures.Develop and implement effective solutions to improve claim processing efficiency and...

Job Title: Registered Nurse - HEDIS AbstractorLocation: Remote or On-Site in the United StatesEstimated Salary: $70,000 - $90,000 per yearAbout HireOps Staffing LLCHireOps Staffing LLC is a leading healthcare staffing agency providing top talent to medical facilities across the United States.Job DescriptionThe Registered Nurse - HEDIS Abstractor will be...

Job Title: Medical Review SpecialistEstimated Salary:$120,000 - $150,000 per yearThe University of Texas Southwestern Medical Center is seeking a highly skilled Medical Review Specialist to join our team. As a key member of our healthcare quality assurance team, you will be responsible for conducting medical necessity reviews and ensuring that patients...

Job OverviewCorroHealth is a leading provider of healthcare solutions, dedicated to helping clients achieve financial health goals. We seek an experienced Clinical Expert in Healthcare Compliance and Utilization Review to join our team.About the RoleThis critical position involves evaluating hospitalizations across the country, utilizing clinical knowledge...

Job Description:As a Utilization Review Clinician at Elite, you will be responsible for evaluating medical treatment requests to determine their medical necessity. Using clinical expertise and evidence-based guidelines, you will review requests submitted by providers, requestors, claimants, or carriers to ensure they meet established standards. To be...

**Job Summary:**We are looking for a detail-oriented Registered Nurse with expertise in clinical documentation to join our team. As a CDI Specialist, you will review and improve clinical documentation in an acute care setting. The ideal candidate has CCDS certification and three years of experience in CDI.Responsibilities:Clinical documentation review and...

Amedisys Inc seeks a dedicated and experienced Clinical Manager for our Hospice team. This role is an excellent opportunity to make a meaningful impact on the lives of patients and their families, providing compassionate care in the comfort of their own homes.About UsWe are a leading provider of home health and hospice care services across the United States....

An award-winning facility, Dallas Metro Hospital, is seeking a seasoned Operational Nurse Lead to oversee the Operating Room. As part of its major expansion, the hospital requires innovative leaders to train and manage its growing staff.The selected candidate will have the opportunity to work with a team that values excellence in patient care. With numerous...

About the RoleWe are looking for a highly motivated and compassionate Clinical Healthcare Specialist to join our team. As a Clinical Healthcare Specialist, you will be responsible for providing direct patient care and supporting the nursing staff.Key Responsibilities:Deliver high-quality patient care that meets the highest standards of safety and...

About UsUT Southwestern Medical Center has been a leader in healthcare excellence for over 75 years. Our commitment to innovation, teamwork, and compassion drives us to provide exceptional patient care and create opportunities for professional growth.Career OpportunitiesWe invite experienced RNs to join our team as a Risk Manager in the Legal Affairs...

**About the Role:**TTF is seeking a highly skilled Registered Nurse with experience in Clinical Documentation Improvement (CDI) to work remotely. This full-time, direct-hire position offers a competitive starting salary of $46-$48/hour and comes with comprehensive benefits.Key Responsibilities:Clinical documentation review and improvementCCDS certification...

Job OverviewWe are seeking a highly skilled Clinical Documentation Improvement Specialist to join our team at Methodist Health System. In this role, you will be responsible for providing leadership and day-to-day coordination within the clinical documentation improvement department. Your expertise in CDI scope of duties will ensure accurate and compliant...

Job Title: Clinical Nurse Coordinator NICU RN Healthcare Specialist About the Role:The TalentBurst, Inc is seeking an experienced and skilled Clinical Nurse Coordinator to join our team. As a key member of our healthcare staffing solutions, you will be responsible for delivering high-quality patient-centered care and coordination of all functions in the...

Nursing Role at Texas OncologyThe Registered Nurse-Float position at Texas Oncology offers a unique opportunity to work in a dynamic and fast-paced healthcare environment. As a member of our nursing team, you will be responsible for providing high-quality, patient-centered care to individuals with cancer. Your expertise and compassion will make a meaningful...

About the Position:We are seeking a highly skilled Medical Support Specialist to join our team at BioLife Plasma Services. As a key member of our operations team, you will play a critical role in ensuring the highest level of patient care and safety.As a Medical Support Specialist, you will be responsible for determining donor eligibility, managing donor...

Care Coordination OpportunityInova Health System is seeking a Clinical Case Manager to join our care coordination team. This role is responsible for coordinating care throughout the continuum of care for an assigned patient population.About the RoleCollaborate with patients, families, and healthcare professionals to develop and implement plans of...

Job Summary: We are seeking an experienced Clinical Documentation Improvement (CDI) professional to lead our team in improving the quality and accuracy of patient documentation. The Team Lead will be responsible for providing leadership, day-to-day coordination, and supervision within the clinical documentation improvement department.">About Us: Methodist...

Job Title: Clinical Nurse SpecialistLocation: Dallas, TexasAbout the Role:We are seeking a highly skilled and experienced clinical nurse specialist to join our trauma unit at Baylor University Medical Center. As a clinical nurse specialist, you will play a critical role in providing high-quality patient care and leading our team of nurses in evidence-based...