Clinical Review Specialist

Job Title: Clinical Utilization Review SpecialistJoin Centene Corporation, a leading healthcare company, as a Clinical Utilization Review Specialist. In this role, you will play a critical part in ensuring the quality and appropriateness of care for our 28 million members.Job Summary:We are seeking a highly skilled Clinical Utilization Review Specialist to...

Job SummaryThis position is responsible for conducting clinical reviews and determining eligibility for children to receive services through the Safety Net program.Key Responsibilities:Conduct thorough clinical reviews to assess the needs of children and their families.Determine eligibility for services based on established criteria.Collaborate with...

Job Title: Nurse ReviewerMedRisk is seeking a skilled Nurse Reviewer to join our team in our utilization review program. As a Nurse Reviewer, you will play a critical role in promoting quality outcomes and enhancing the physical, psychosocial, and vocational health of individuals.Job Summary:The Nurse Reviewer will apply technical knowledge and experience to...

Are you looking for a work environment where diversity and inclusion thrive? Submit your application for our RN Clinical Reviewer opening with HCA Houston Healthcare Northwest today and find out what it truly means to be a part of the HCA Healthcare team. HCA Houston Healthcare Northwest, offers a total rewards package that supports the health, life,...

Job SummaryAs a Clinical Review Director at HMSA, you will play a critical role in ensuring compliance with medical and benefit policies, nationally recognized clinical review criteria, accreditation guidelines, and governmental regulations. Your expertise will be essential in directing and evaluating clinical review activities to guarantee accuracy,...

Job Title: Proposal Review SpecialistWe are seeking a highly organized and detail-oriented Proposal Review Specialist to join our team at the Ross and Carol Nese College of Nursing. The successful candidate will have excellent written and verbal communication skills, be able to learn and navigate new research quickly, and enjoy taking on new challenges.Key...

Description IntroductionAre you looking for a work environment where diversity and inclusion thrive? Submit your application for our RN Clinical Reviewer opening with HCA Houston Healthcare Northwest today and find out what it truly means to be a part of the HCA Healthcare team.BenefitsHCA Houston Healthcare Northwest, offers a total rewards package that...

Job SummaryWe are seeking a highly skilled Licensed Utilization Review Specialist to join our team at Elevance Health. As a key member of our medical management team, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care possible.Key ResponsibilitiesConduct thorough reviews of medical necessity and...

Job Title: LPN Utilization Review SpecialistPyramid Consulting is seeking a skilled LPN to fill a Utilization Review position in a local contract role.Job SummaryWe are looking for a dedicated LPN to work as a placement coordinator, utilization review, and discharge planning specialist.Key ResponsibilitiesConduct thorough utilization reviews to ensure...

Job Title: Grant Application Review SpecialistCorner Alliance is a dynamic consulting firm dedicated to delivering exceptional results for the government. We are seeking a skilled Grant Application Review Specialist to join our team and contribute to our mission.About the Role:As a Grant Application Review Specialist, you will work with our Federal...

Job Title: Analytical Data Review SpecialistWe are seeking a highly skilled Analytical Data Review Specialist to join our team at PL Developments. As an Analytical Data Review Specialist, you will be responsible for reviewing and ensuring the accuracy of analytical data for pharmaceutical products.Key Responsibilities:Finalize the review of analytical data,...

Job Details **Job Title:** LPN Utilization Review Specialist **Job Type:** Local Contract **Location:** Fontana, California **Job Description & Requirements **Specialty:** Utilization Review **Discipline:** LPN/LVN **Job Summary:** Pyramid Consulting is seeking a skilled LPN/LVN to work as a placement coordinator, utilization review, and discharge...

Join Our Team as a RN Clinical ReviewerWe are seeking a highly skilled RN Clinical Reviewer to join our team at HCA Houston Healthcare Kingwood. As a RN Clinical Reviewer, you will play a critical role in ensuring the highest quality of care for our patients.About the RoleThe RN Clinical Reviewer will be responsible for reviewing and analyzing clinical data...

Job Title: Clinical Reviewer - ABA ServicesJoin Centene Corporation, a leading healthcare company, as a Clinical Reviewer - ABA Services. In this role, you will be responsible for reviewing member care and health status to determine medical appropriateness of Applied Behavioral Analysis (ABA) services.Key Responsibilities:Evaluate member care and health...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Performs a clinical review and assesses care related to mental...

Job Title: Environmental Review Compliance SpecialistICF is seeking an Environmental Review Compliance Specialist to help manage federal grants to recover from disasters and conduct strategic and high-impact activities to mitigate disaster risks and reduce future losses in communities.Key Responsibilities:Assist with program compliance with U.S. Department...

Job Title: LPN Utilization Review SpecialistPyramid Consulting is seeking a skilled LPN to fill a Utilization Review position in Fontana, California.Job DescriptionSpecialty: Utilization ReviewDiscipline: LPNEmployment Type: Local ContractThe ideal candidate will have experience in placement coordination, utilization review, and discharge planning. This is a...

Job Title: Clinical Research Nurse SpecialistThis is a full-time position that reports directly to the Senior Director of the Department of Site and Study Management.Job Summary:The Clinical Research Nurse Specialist will provide clinical expertise to support the facilitation of new clinical trials from concept through development and launch. The individual...

Job Details Job Title: LPN Utilization Review Specialist Job Type: Local Contract Location: Fontana, California Job Description: Pyramid Consulting is seeking a skilled LPN to fill a Utilization Review position on a local contract basis. As a key member of our team, you will be responsible for placement coordination, utilization review, and discharge...

Job Title: Clinical Documentation Specialist RNShaker for ChristianaCare Direct is seeking a skilled Clinical Documentation Specialist RN to support the documentation process and improve the quality of clinical documentation.About the Role:This is a hybrid position that requires remote and onsite work. The successful candidate will work closely with...