Clinical Utilization Review Specialist

h3Job Description/h3pAt Nexus Health Systems Ltd, we are seeking a skilled bClinical Utilization Review Specialist/b to join our team. As a key member of our healthcare team, you will play a vital role in ensuring the delivery of cost-effective quality care within an appropriate length of stay./ppbKey Responsibilities:/b/pulliMaintain patient confidentiality...

Job Title: Utilization Management Review NurseAbout the Role:Astrana Health is seeking an experienced Utilization Review Nurse to work remotely from Texas. This position requires working Monday through Friday from 8:30 a.m. to 5 p.m., with occasional weekend and holiday coverage as needed.Key Responsibilities:1. Conduct prior authorization and retrospective...

Job SummaryThe Utilization Review Nurse is responsible for ensuring the medical necessity of patient admissions and continued stays. This role involves reviewing patient medical records, evaluating the appropriateness of care, and communicating with payors regarding clinical updates.Key Responsibilities Reviews patient medical records to collect data and...

Job SummaryThe Utilization Review Nurse is responsible for ensuring the medical necessity of patient admissions and continued stays. This role involves reviewing patient medical records, evaluating the appropriateness of care, and collaborating with healthcare teams to optimize resource utilization.Key Responsibilities* Review patient medical records to...

Job Summary:As a Utilization Review Nurse at Care, you will play a vital role in ensuring the highest quality patient care while promoting efficient resource utilization. Your expertise will be instrumental in facilitating critical criteria reviews, collaborating with managed care organizations, and maintaining accurate records. If you are a dedicated and...

Job TitleNurse Utilization SpecialistJob Summary:Elite is seeking a skilled Nurse Utilization Specialist to join our team. 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.Responsibilities:Conduct thorough evaluations...

Job Title: Clinical Review NurseJob Summary:HealthHelp, a WNS Global Services company, is seeking a skilled Clinical Review Nurse to join our team. As a Clinical Review Nurse, you will play a critical role in ensuring the quality and safety of patient care by reviewing medical necessity criteria and facilitating resolution of escalated cases.Key...

Job SummaryHealthHelp, a leading provider of healthcare utilization and care management services, is seeking a skilled Clinical Review Nurse to join our team. As a key member of our clinical review team, you will play a critical role in ensuring the quality and safety of patient care.Key ResponsibilitiesPerform thorough clinical reviews of cases to determine...

Job SummaryWe are seeking a skilled Utilization Management Clinical RN to join our team. In this role, you will be responsible for providing precertification of inpatient hospitalizations and outpatient procedures, as well as conducting telephonic and concurrent reviews of inpatient hospitalizations and extended courses of outpatient treatment.Key...

Job Title: Utilization Management Review NurseAbout the Role:Astrana Health is seeking an experienced Utilization Review Nurse to work remotely from Texas. This position requires a strong understanding of state and federal regulations and accreditation standards. The ideal candidate will have excellent interpersonal skills and the ability to collaborate with...

Job DescriptionSafe Place Counseling & Consulting, LLC is seeking a skilled Clinical Assessor/Reviewer to join our team. As a remote assessment specialist, you will conduct thorough intake/risk/triage behavioral health assessments to identify patients' appropriate level of care.ResponsibilitiesWelcome patients to the agency and conduct comprehensive...

Job SummaryUPS Industrial Services is seeking a skilled Contract Review Specialist to join their team. The successful candidate will be responsible for drafting, reviewing, and negotiating contracts and agreements for clients and subcontractors in various industries.Key Responsibilities:Coordinate the review of contract documents to identify potential risks...

Job Summary:Amergis is seeking a skilled Utilization Management Clinical RN to join our team. As a key member of our team, you will be responsible for analyzing submitted information, creating case summaries, and collaborating with medical directors to ensure accurate and timely decision-making.Responsibilities:Analyze clinical assessments, treatment plans,...

Job OpportunityWe are seeking a skilled Clinical Assessor/Reviewer to join our team at Safe Place Counseling & Consulting, LLC.Job SummaryThis is a rewarding role that offers the opportunity to make a meaningful difference in the lives of individuals and families. As a Clinical Assessor/Reviewer, you will conduct thorough intake/risk/triage behavioral health...

Morae Global is seeking a skilled Document Review Specialist to join our team in Houston, Texas. As a key member of our document review project, you will be responsible for conducting detailed reviews of documents for relevance, privilege, and confidentiality.Key Responsibilities:Conduct thorough reviews of documents to ensure accuracy and quality.Accurately...

Job Title: Clinical SpecialistRegency Integrated Health Services is seeking a highly skilled Clinical Specialist to join our team. As a Clinical Specialist, you will play a critical role in ensuring the highest level of care for our residents.Key Responsibilities:Provide expert guidance and support to facility administrators and directors of nursingReview...

 Job Title: Clinical Assessment Specialist Job Summary: Regency Integrated Health Services is seeking a skilled Clinical Assessment Specialist to join our team. As a key member of our care management team, you will be responsible for coordinating the Resident Assessment Instrument (RAI) process to ensure accurate and timely completion of resident...

About the JobWe are seeking a highly skilled Senior Pharmacy Clinical Specialist to join our team. As a key member of our pharmacy department, you will be responsible for providing expert clinical pharmacy services to patients in the oncology area.Key ResponsibilitiesProvide expert clinical pharmacy services to patients in the oncology area, including...

Job Title: Mobile Research NurseJob Type: Contract, PRN, Per diemHourly Rate: $55/hr onsite and $50/hr travel timeWork Location: Houston, Texas; On the roadJob Description:We are seeking a dedicated individual with current acute care or homecare experience and phlebotomy skills to work under the guidance of the principal study investigator and nursing...

Job SummaryWe are seeking a highly skilled and experienced Regional Director to lead our clinical research operations. The successful candidate will provide strategic leadership, project management, and oversight for multiple locations, ensuring the successful execution of clinical trials in accordance with Sponsor goals, Standard Operating Procedures...