Clinical Utilization Review Specialist

Job SummaryWe are seeking a skilled Clinical Utilization Review Specialist to join our team at Memorial Health University Medical Center. As a key member of our healthcare team, you will play a critical role in ensuring the efficient use of acute care services.Key ResponsibilitiesConduct thorough clinical reviews of patient records to evaluate the...

Job Summary:Trinity Health is seeking a skilled Registered Nurse to fill the role of Clinical Utilization Review Specialist. This position will be responsible for performing utilization review with payers, assisting physicians with level of care determinations, and promoting improvements in work processes within the department, hospital, and community.Key...

Job SummaryWe are seeking a highly skilled Utilization Review Resource Specialist to join our team at CoxHealth. In this role, you will be responsible for facilitating and accurately documenting insurance authorization information, responding to requests from the utilization review department and central access department, and maintaining organization in a...

Job SummaryCVS Health is seeking a skilled Clinical Utilization Management Specialist to join our team. As a Utilization Management Nurse Consultant, you will play a critical role in coordinating and documenting all aspects of the utilization/benefit management program.You will utilize your clinical expertise to ensure members receive the appropriate care at...

Job SummaryWe are seeking a highly skilled Licensed Practical Nurse (LPN) to join our team as a Clinical Utilization Reviewer. In this role, you will work collaboratively with our healthcare team to provide high-quality patient care and ensure that our members receive the necessary services to achieve optimal health outcomes.Key ResponsibilitiesUnder the...

Job Title: Utilization Management Nurse ConsultantAt CVS Health, we're committed to delivering enhanced human-centric healthcare for a rapidly changing world. As a Utilization Management Nurse Consultant, you'll play a critical role in coordinating, documenting, and communicating all aspects of our utilization/benefit management program.Key...

Job Title: Utilization Management Nurse ConsultantCareers at CVS HealthAbout the Role:We are seeking a highly skilled Utilization Management Nurse Consultant to join our team. As a Utilization Management Nurse Consultant, you will play a critical role in ensuring that our members receive the most appropriate care at the right time and in the right...

Transforming Healthcare TogetherEvolent Health partners with health plans and providers to deliver better health outcomes for individuals with complex and costly health conditions. As a key member of our utilization management team, you will play a vital role in ensuring patients receive the same level of care and compassion we would want for our loved...

Job SummaryCVS Health is seeking a skilled Clinical Review Nurse Consultant to join our team. As a key member of our clinical review team, you will be responsible for reviewing and evaluating clinical information and documentation to ensure compliance with regulatory and accreditation requirements.Key Responsibilities:Review and interpret clinical records...

About the RoleCVS Health is seeking a skilled Clinical Review Nurse Consultant to join our team. As a key member of our clinical review team, you will play a critical role in ensuring the quality and accuracy of our clinical information and documentation.Key ResponsibilitiesReview and evaluate clinical information and documentation to ensure compliance with...

About the RolePinnacle Clinical Research is seeking a highly skilled and detail-oriented Clinical Research Associate to join our team. As a Clinical Research Associate, you will play a critical role in the success of our clinical trials by ensuring the highest quality of data collection and management.Key ResponsibilitiesConduct Psychometric Rating Scales:...

About the RolePinnacle Clinical Research is seeking a highly skilled Clinical Research Rater to join our team. As a key member of our research team, you will be responsible for administering and interpreting quantitative and qualitative tests to measure neurological and psychological variables related to various diseases.Key ResponsibilitiesMeet with...

Job Summary:The Neurosurgery Clinical Specialist will be a member of a multidisciplinary team responsible for the evaluation and treatment of neurosurgery patients. The ideal candidate will have a strong background in nursing and a passion for delivering high-quality patient care.Key Responsibilities: Provides and coordinates delivery of care for patients...

Transforming Healthcare with Utilization ManagementAt UnitedHealth Group, we're redefining healthcare by integrating programs across the entire continuum of care. As a Utilization Management Nurse, you'll play a critical role in ensuring the integrity of adverse determination processes and accuracy of clinical decision making.Key...

Job SummaryWe are seeking a highly skilled Medical Review Officer to join our team at QTC Company. As a Medical Review Officer, you will be responsible for providing clinical leadership and expertise in the review of medical examination results.The selected candidate will have a strong clinical background, with a minimum of five years of out-patient clinical...

Flight Nurse - Critical Care SpecialistAt Air Methods Clinical, we are seeking a highly skilled Flight Nurse to join our team. As a Flight Nurse, you will be responsible for providing critical care to patients in need of medical transport. Your expertise will be invaluable in ensuring the safe transport of patients to the appropriate medical...

Job SummaryThe Clinical Documentation Improvement (CDI)/Utilization Review Manager will oversee the day-to-day functions of both programs to ensure their success across the organization. As the CDI Manager, they will ensure that CDI Nurses perform clinical documentation validations timely and efficiently, adhering to regulatory compliance requirements for...

Nurse Reviewer II Job SummaryThis position is responsible for coordinating and conducting various review activities as defined by HSAG's contract with the State of Hawaii, Department of Human Services MedQUEST Division (DHS/MQD).The Nurse Reviewer II will use professional judgment to apply established screening criteria to conduct long-term care level of...

Job SummaryWe are seeking a highly skilled and compassionate Clinical Nurse Specialist to join our team at SIU Medicine. The successful candidate will provide expert nursing care and support to our patients and healthcare team in the Department of Obstetrics and Gynecology.Key ResponsibilitiesProvide high-quality nursing care and treatment to obstetrical and...

We are seeking a skilled Clinical Nurse Specialist to join our team at DOCS Health. As a trusted industry leader, we provide high-quality healthcare services to our Military Service members.The ideal candidate will have a strong background in nursing and excellent communication skills. They will be responsible for supporting Physical Health Assessments of...