Physician Reviewer

Job OpportunityWe are seeking a skilled Physician Reviewer to join our team at Dane Street, LLC.About the RoleThe successful candidate will utilize their clinical expertise to review insurance appeals, prospective and retrospective claims, and provide an interpretation of the medical necessity of services provided by other healthcare professionals.Key...

Job SummaryUT Southwestern Medical Center is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate level of care while minimizing unnecessary hospital stays.Key ResponsibilitiesConduct medical certification reviews for medical necessity...

Job SummaryValor Healthcare, Inc. is seeking a highly skilled Medical Review Officer to join our team. As a key member of our healthcare team, you will be responsible for reviewing medical examinations and consultation requests to ensure quality control and consistency.Key Responsibilities:Review medical examinations and consultation requests to ensure...

Job Title: Medical Review SpecialistConcentra is seeking a Medical Review Specialist to join our team. As a Medical Review Specialist, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family...

Job SummaryAs a Clinical Utilization Review Specialist at the University of Texas Southwestern Medical Center, you will play a crucial role in ensuring the highest quality of care for our patients. Your primary responsibility will be to conduct medical certification reviews for medical necessity for acute care facilities and services.You will use nationally...

Job SummaryAs a Clinical Utilization Review Nurse at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the highest quality of care for our patients. Your primary responsibility will be to conduct medical certification reviews for medical necessity for acute care facilities and services. You will use nationally...

Job Title: Clinical Review NurseJob Summary:Elite PC Services is seeking a skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in reviewing Workers Compensation requests to determine medical necessity. Your expertise will be utilized to analyze medical data, apply evidence-based guidelines, and make...

Job Title: Utilization ReviewrnAt Children's Health, our mission is to Make Life Better for Children for 110 years, and generation to come. We recognize that their health plays a crucial role in achieving this goal.Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience,...

Job SummaryAs a Clinical Utilization Review Nurse at the University of Texas Southwestern Medical Center, you will play a critical role in ensuring the appropriate level of care for patients. You will conduct medical certification reviews for medical necessity, using nationally recognized guidelines to recommend the level of care to physicians. Your...

Job Title: Neurologist Medical Review SpecialistConcentra is seeking a skilled Neurologist Medical Review Specialist to join our team. As a Medical Review Specialist, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.Responsibilities:Reviews...

Job Title & Specialty Area:Utilization Management RNDepartment:Utilization ReviewLocation:DallasShift:Day, M-F (This position does provide some flexibility in start/end time, and does require availability to be on campus for meetings)Job Type:RemoteAbout the Role:The Utilization Management Nurse is responsible for determining and managing medical necessity...

Job SummaryAs a Utilization Review Registered Nurse at UT Southwestern Medical Center, you will play a critical role in ensuring the highest quality of care for our patients. Conduct medical certification reviews for medical necessity, utilizing nationally recognized guidelines to recommend the appropriate level of care. Collaborate with physicians and other...

Job Title: Utilization Review RNChildren's Health is seeking a skilled Utilization Review Registered Nurse to join our team. As a Utilization Review RN, you will play a critical role in ensuring that our patients receive the highest quality care while minimizing unnecessary costs.Key Responsibilities:Conduct thorough reviews of patient records to determine...

Job Title: Utilization Review NurseWe are seeking a skilled Utilization Review Nurse to join our team at Children's Health. As a Utilization Review Nurse, you will play a critical role in ensuring that our patients receive the most appropriate and effective care possible.Responsibilities:Conduct thorough reviews of patient records to determine medical...

Job Title: Utilization Review NurseChildren's Health is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that our patients receive the most appropriate and effective care.Responsibilities:Conduct thorough reviews of patient records to determine medical necessity and...

Job SummaryWe are seeking a highly skilled Utilization Review Nurse to join our team at Elite. As a key member of our clinical review team, you will play a critical role in ensuring the medical necessity of treatment requests submitted by providers, requestors, claimants, or carriers.Key ResponsibilitiesMedical Necessity Review: Conduct thorough evaluations...

Job Title: Case Management Utilization Review RNThe Care Manager assumes primary responsibility for ensuring the medical necessity of inpatient status or placement in observation. They communicate effectively with physicians and clinicians, ensuring timely documentation and authorization of patient stays. Collaborating with other healthcare professionals,...

Job SummaryUTMB Health is seeking a highly skilled Physician III to join our team in the Correctional Managed Care Organization. As a key member of our medical staff, you will work under the direction of the Associate Medical Director to provide high-quality patient care and contribute to the successful operations of our organization.Essential Job...

Job SummaryThe Physician Liaison plays a vital role in fostering strong relationships between physicians, healthcare providers, and key stakeholders within the market service area of their assigned hospital. This position serves as a trusted connection, increasing awareness and ease of access to Baylor Scott & White Health services. The Physician Liaison...

Job SummaryChenega Corporation is seeking a highly skilled Physician to provide medical services as a Fee Basis Provider (FBP). The successful candidate will be responsible for conducting medical histories, physical examinations, and reviewing medical tests and documents related to consultations and medical histories.ResponsibilitiesConduct medical histories...