Clinical Utilization Review Specialist

Job SummaryThe Utilization Management Nurse Reviewer plays a vital role in ensuring that medical services are utilized efficiently and effectively. This position requires a strong clinical background, excellent communication skills, and the ability to make informed decisions regarding patient care pathways.Key ResponsibilitiesConduct assessments of medical...

Job Summary:We are seeking a Board Certified Internal Medicine physician to join our medical review team as a telecommute medical review specialist. This is a contract position that offers a flexible schedule and the opportunity to work from home.Responsibilities:Reviews medical files and provides recommendations for utilization review, chart reviews,...

Job SummaryRelying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.ResponsibilitiesReviews...

Job SummaryMedReview LLC is seeking a highly motivated and experienced registered nurse to join our Hospital Bill Review Department. As a Clinical Auditor, you will be responsible for performing bill reviews and chart validations to ensure accuracy and accountability in healthcare. Key ResponsibilitiesConduct thorough reviews of medical records to identify...

Job SummaryVIVIO Health is seeking a highly skilled Therapy Plan Reviewer to join our dynamic team. As a key member of the Therapy Planning Team, you will play a pivotal role in ensuring evidence-based and cost-effective therapy drug management.Key Responsibilities:Review therapy requests pursuant to VIVIO's processes and policiesProvide collaborative...

Job Summary:US Tech Solutions is seeking a skilled Clinical Nurse Consultant to join our team. As a Clinical Nurse Consultant, you will be responsible for reviewing and evaluating clinical information and documentation to ensure compliance with regulatory and accreditation guidelines.Key Responsibilities:Review and evaluate clinical information and...

About the RoleThe Clinical Order Set Specialist will play a critical role in promoting desirable patient outcomes by ensuring the development, implementation, and maintenance of order sets.This position requires a strong background in clinical experience, with a minimum of five years as a registered nurse.The ideal candidate will have experience with order...

Position OverviewWe are seeking a subject matter authority in the care of women in midlife to join our telehealth practice as a clinical moderator for questions and escalations.This role will report to the Medical Director and be responsible for continuous improvement in patient care through supporting our clinicians.ResponsibilitiesModerate Clinical Slack...

Job DescriptionIn this role, you will be part of a dynamic team that drives asset strategy development and execution within established frameworks. The team is responsible for concentrating on asset development until a decision is made to enter Clinical Phase 2A, or proof of concept in patients. After this phase, teams are designated as Asset Strategy Teams....

Job OverviewEnterprise Engineering seeks a skilled Clinical Care Coordinator to promote quality and cost-effective outcomes for a population by facilitating collaboration and coordination across settings.This role involves reviewing patient records and providing recommendations to ensure members receive the services and resources required to meet desired...

Job SummaryWe are seeking a highly skilled Medical Coding Specialist to join our team at TechData Service Company LLC. As a key member of our clinical research team, you will be responsible for delivering accurate and consistent medical coding for all assigned company protocols within established timelines and in compliance with processes, guidelines, and...

Job Title: Medical Information Specialist IIJob Summary:We are seeking a highly skilled Medical Information Specialist II to join our team at Inizio Engage. As a Medical Information Specialist II, you will be responsible for delivering virtual or telephonic support to clients, engaging customers, patients, and/or healthcare professionals in a robust clinical...

About Children's Hospitals and Clinics of MinnesotaAs a leading pediatric health system in the United States, Children's Hospitals and Clinics of Minnesota is dedicated to providing exceptional care to children from birth through young adulthood.Our organization is committed to excellence in patient care, education, and research, and we are proud to be...

About Children's Hospitals and Clinics of MinnesotaWe are a pediatric health system in the United States, providing care exclusively to children from birth through young adulthood.Our organization is an independent and not-for-profit system since 1924, serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics,...

About the RoleThe Molecular Oncology Specialist is a senior sales role primarily responsible for establishing growth within an assigned territory through new account acquisition.The responsibilities include identifying, prospecting, and closing new business at potential accounts, mentoring the Account Managers within the territory by acting as the Subject...

Billing Specialist Job DescriptionVasquez Law Firm PLLC is seeking a highly skilled Billing Specialist to join our team. The ideal candidate will have a strong background in accounting and billing, with excellent communication and organizational skills.Key Responsibilities:Review and edit bills for accuracy and completenessCoordinate with billers to ensure...

Job SummaryAt SHI GmbH, we are seeking a skilled Software Development Specialist to join our team. As a key member of our software development team, you will be responsible for designing, coding, testing, implementing, and supporting application software that meets the highest standards of quality and reliability.About the RoleThis is an exciting opportunity...

Job Title: Business Tax SpecialistJob Summary:We are seeking a highly motivated Business Tax Specialist to join our team at Intuit. As a Business Tax Specialist, you will be responsible for providing expert guidance and tax preparation services to our customers. You will work closely with our team to deliver high-quality customer interactions and experiences...

About DexcomDexcom is a pioneer and global leader in continuous glucose monitoring (CGM). Our mission is to improve human health by developing innovative solutions for serious health conditions. We are driven by a passion for making a difference in people's lives and a commitment to excellence in everything we do.Job SummaryWe are seeking a highly skilled...

Job Title: Cyber Security Detection SpecialistAbout the Role:We are seeking a highly skilled Cyber Security Detection Specialist to join our team at The Dignify Solutions LLC. As a Cyber Security Detection Specialist, you will be responsible for developing, implementing, and verifying baseline and advanced detection strategies for Microsoft Azure.Key...