Clinical Review Specialist

Job Summary:As a Clinical Review Nurse - Concurrent Review Specialist at Axelon, you will play a critical role in ensuring the quality and appropriateness of care delivered to our members. Your expertise in concurrent review will enable you to evaluate the necessity and setting of care being delivered, contributing to discharge planning according to care...

Job SummaryAs a Clinical Review Coordinator at UnitedHealth Group, you will play a critical role in ensuring the quality and accuracy of clinical information. Your primary responsibility will be to request and review members' clinical information from providers, utilizing Interqual Criteria to perform utilization reviews and update authorizations in a timely...

About UsGeorge Clinical is a leading global clinical research organization founded in Asia-Pacific, driven by scientific expertise and operational excellence. With over 20 years of experience and a team of over 500 people managing 40+ geographical locations worldwide, we offer a full range of clinical trial services to biopharmaceutical, medical device, and...

Job Summary:As a Clinical Review Nurse - Prior Authorization Specialist at Axelon, you will play a critical role in analyzing prior authorization requests to determine medical necessity and appropriate level of care. Your expertise in clinical knowledge and ability to analyze authorization requests will be essential in promoting quality and...

Job Title: Hemophilia Clinical ReviewerPrime Therapeutics is seeking a highly skilled Hemophilia Clinical Reviewer to join our team. As a Clinical Reviewer, you will play a critical role in facilitating the development of medical pharmacy solutions programs.Key Responsibilities:Support drug utilization review (DUR) efforts by reviewing physician prescribing...

Job Summary:The Clinical Nurse Specialist at CareerNation provides professional nursing care to patients/significant others via direct contact, following established standards and practices. The ideal candidate will coordinate with other members of the care team to ensure seamless care delivery, maximal coordination of efforts, and active patient...

Job Title: Senior Medical Coding ReviewerJoin Centene Corporation, a leading healthcare company, as a Senior Medical Coding Reviewer. In this role, you will play a critical part in ensuring the accuracy and compliance of medical coding practices across our organization.Key Responsibilities:Perform medical claim reviews to ensure compliance with coding...

Job Summary:CVS Health is seeking a skilled Nurse Consultant to join our team in Utilization Management. As a key member of our team, you will play a critical role in ensuring that our members receive the most appropriate care at the right time and in the right location.About the Role:This is a remote position that requires a strong clinical background and...

Job SummaryWe are seeking a highly skilled Plan Review Specialist to join our team at the City of North Kansas. The successful candidate will be responsible for reviewing plans and construction documents to ensure compliance with City Codes.Key ResponsibilitiesReview plans, specifications, and calculations for building code compliance and assist with the...

Job SummaryCVS Health is seeking a skilled Utilization Management Nurse Consultant to join our team. As a key member of our healthcare team, you will play a vital role in ensuring that our members receive the most appropriate care at the right time and in the right location.Key ResponsibilitiesUtilize clinical expertise to coordinate, document, and...

Clinical Pharmacist - Care and Medication ManagementCentene Corporation is seeking a highly skilled Clinical Pharmacist to join our Medical Management/Health Services team. As a key member of our team, you will play a critical role in improving disease state outcomes and medication-related safety for our 28 million members.Key Responsibilities:Manage...

Job OverviewWe are seeking a highly skilled Accounting Specialist to join our team at InfoTree.The ideal candidate will have proven experience in bookkeeping, finance, or a related field, with a strong background in SAP and accounting principles.Responsibilities will include reviewing, verifying, and processing supplier invoices for payment, as well as...

Job Summary:Instrumentl is seeking a highly organized and detail-oriented Data Entry Specialist to join our team. As a Data Entry Specialist, you will be responsible for accurately and efficiently entering grant information into our database. You will also review and validate the accuracy of grant details, making necessary edits to ensure completeness and...

Quality Assurance SpecialistHitachi Energy is seeking a Quality Assurance Specialist for our factory located in Jefferson City, MO. The successful candidate will be responsible for reviewing and coordinating quality assurance and quality control specifications. They will develop or evaluate quality programs, measure quality activities, and coordinate quality...

Job OverviewAs a Nurse Clinical Research Coordinator at Avacare, you will play a crucial role in coordinating and participating in clinical research studies. Your primary responsibility will be to ensure that studies are conducted according to protocol, good clinical practice, and relevant regulations. This is an exciting opportunity to contribute to...

Job Title: Quality Assurance SpecialistHitachi Energy is seeking a Quality Assurance Specialist to join our team in Jefferson City, MO.Job Summary:We are looking for a highly skilled Quality Assurance Specialist to review and coordinate quality assurance and quality control specifications. The ideal candidate will have a strong analytical background and...

Job Title: Loan Services SpecialistAbout the Role:We are seeking a detail-oriented Loan Services Specialist to join our team at FCS Financial. As a key member of our team, you will be responsible for reviewing and preparing loan documents, ensuring accuracy and adherence to regulations and Association policies and procedures.Key Responsibilities:* Review and...

About the RoleMU Health Care is seeking a skilled and experienced clinical nurse supervisor to join our team. As a key member of our internal medicine clinic, you will be responsible for providing leadership and guidance to our nursing staff, ensuring the delivery of high-quality patient care and promoting a positive work environment.Key...

Hospice Care SpecialistLHC Group is seeking a skilled Hospice Care Specialist to provide compassionate end-of-life care to patients and their families in Jefferson City, Missouri.Key Responsibilities:Conduct comprehensive and timely delivery of hospice care after regular business hours, including at night and on weekends.Triage patient needs over the phone...

Job Summary:We are seeking a highly skilled and experienced Behavior Clinic Supervisor to join our team at BrightSpring Health Services. As a key member of our Youth Behavioral Clinic, you will be responsible for providing leadership and guidance to our team of behavior analysts and technicians. Your expertise will be instrumental in developing and...