Care Review Clinician, Inpatient Review

Role OverviewThe Facility Compliance Review team at Blue Shield of CA reviews post-service prepayment facility claims for contract compliance, industry billing standards, and medical necessity. As a Utilization Management Nurse, Senior, you will be responsible for reviewing medical documents and applying clinical criteria to establish the most appropriate...

Job Title: Clinical Reviewer LVNJob Type: Full-timeLocation: RemoteAbout Us:At Advanced Medical Manage, we are dedicated to providing high-quality healthcare services to our members. We are seeking an experienced Clinical Reviewer LVN to join our team.Job Summary:The Clinical Reviewer LVN will be responsible for reviewing requests for service authorizations...

About the Position:Molina Healthcare is seeking a highly skilled Clinical Review Nurse to join our team as a SIU Investigator. As a Clinical Review Nurse, you will be responsible for reviewing and analyzing information to make medical determinations and applying clinical knowledge to assess the medical necessity of services.Responsibilities:Review and...

About the RoleThis is an exciting opportunity for a skilled nurse to join our Utilization Management team as a Clinical Review Nurse. In this role, you will be responsible for conducting thorough reviews of prior authorization requests, analyzing medical records, and making informed decisions regarding coverage.You will work closely with our Medical Director...

About the Role:Molina Healthcare Services (HCS) seeks an experienced Inpatient Review Clinician to join our team. As an integral member of our multidisciplinary team, you will collaborate with healthcare professionals to deliver high-quality, patient-centered care and drive positive patient outcomes.Main Responsibilities:Assess inpatient services for members...

ResponsibilitiesPerform retrospective utilization reviews and first-level determination approvals for members using evidence-based guidelines, policies, and nationally recognized clinical criteria.Conduct clinical review of claims for medical necessity, coding accuracy, medical policy compliance, and contract compliance.Prepare and present cases to Medical...

Job Title: Medical Record Review and Analysis ManagerAbout Our Organization: Molina Healthcare is a mission-driven organization dedicated to improving the lives of our members and the communities we serve. We are seeking an experienced Medical Record Review and Analysis Manager to join our team.Salary: The estimated annual salary for this position is around...

Job OverviewDenovo Review, a leader in pharmaceutical and medical device litigation, seeks an experienced Senior Trial Attorney to join our team. With 7+ years of trial experience and expertise in brief writing & deposition, this role presents an opportunity for growth and development.The successful candidate will have a proven track record of prosecuting...

Homebase Medical is seeking a dedicated and compassionate Primary Care Clinician to join our team as a Part-time Home Visit Healthcare Provider. In this autonomous role, you will provide high-quality primary care to patients in their homes, Board and Care facilities, and Assisted Living facilities.Key Responsibilities:Conduct comprehensive assessments,...

Job OverviewWe are seeking a highly experienced Senior Trial Attorney to join our team at Denovo Review in Newport Beach. This role offers an exciting opportunity for an accomplished litigator with expertise in pharmaceutical litigation and mass tort cases.The ideal candidate will have a strong track record of success in trial experience, including brief...

Job TitleSenior Trial AttorneyDescriptionDenovo Review is a leading law firm in Newport Beach, seeking a skilled Senior Trial Attorney to join our team. This role presents an opportunity to work on high-profile pharmaceutical, medical device, and dietary supplement litigation cases.Familiarity with State and Federal District Courts is essential, as you will...

ResponsibilitiesAs a Sr. Manager, Utilization Management Nurse Management, you will:Manage a high-functioning team with direct oversight of day-to-day operationsParticipate in process improvement/cost of health care initiativesHave a bachelor's degree or equivalent experienceHold a current California RN LicenseHave at least 10 years of prior relevant...

About De Novo Review Inc.De Novo Review Inc. is a respected law firm with a strong reputation for handling complex pharmaceutical, medical device, and dietary supplement litigation cases in State and Federal District Courts. Our team of skilled lawyers has earned a national recognition as effective mass tort advocates, having participated in leadership roles...

Key ResponsibilitiesLead cases in State and Federal District Courts, utilizing expertise in brief writing and depositionDevelop and implement strategies for achieving optimal case outcomesCollaborate with cross-functional teams to drive client successBenefits:Competitive salary range: $100-150kHybrid work arrangement with remote and in-office optionsDynamic...

Job SummaryWe are seeking a Part-time Advanced Practice Clinician (Physician Assistant or Nurse Practitioner) to join our team at Homebase Medical.As a key member of our healthcare team, you will be responsible for delivering high-quality patient care in the comfort of their own homes, utilizing our partner clinic in the South Orange County...

Job DescriptionWe are seeking an experienced Case Management Manager to join our team at Advanced Medical Manage.ResponsibilitiesReview inpatient cases and provide guidance to case managers for reviews, hospital transfers, observation, discharge planning, and transitions of care.Review outpatient cases and provide guidance to case managers for reviews, case...

About the Job: We are seeking a skilled Physician Assistant to join our team in an inpatient rehabilitation setting. As a member of our team, you will work closely with physicians and other healthcare professionals to provide high-quality patient care. This is an excellent opportunity for a motivated and compassionate individual who is looking to make a...

Job DescriptionSoliant Health is currently seeking a skilled Inpatient/IV Pharmacy Technician for an immediate temporary assignment at a hospital in Los Angeles County. This opportunity requires flexibility to start soon, with the possibility of transitioning from full-time to part-time hours.The ideal candidate will possess at least one year of recent...

Job OverviewSoliant is seeking a skilled and experienced Staff Pharmacist to support inpatient duties during a potential strike coverage situation in Michigan.This temporary role offers a unique opportunity to work with a local hospital, providing high-quality patient care while demonstrating flexibility and adaptability.

About the Role: CHG Healthcare is seeking a highly skilled Physician Assistant to join our team in an inpatient rehabilitation setting. As a member of our team, you will play a critical role in delivering high-quality patient care and contributing to a positive patient experience. This is an exciting opportunity for a motivated and compassionate individual...