Clinical Review Nurse

Job SummaryCorVel Corporation is seeking a highly skilled Clinical Review Specialist II to join our team. As a Clinical Review Specialist II, you will play a critical role in ensuring the medical necessity of in-patient admissions and out-patient treatment, while supporting the goals of our Case Management department.Key ResponsibilitiesConduct thorough...

About the RoleWe are seeking a highly skilled and experienced Pre-Service Review Coordinator to join our team at UnitedHealth Group. As a key member of our clinical review team, you will play a critical role in ensuring the medical appropriateness of pre-authorization requests.Key ResponsibilitiesReview and determine medical appropriateness of...

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 Opportunity at Dane Street, LLCJob Title: Physician ReviewerJob Summary:Dane Street, LLC is seeking a highly skilled Physician Reviewer to join our team. As a Physician Reviewer, you will utilize your clinical expertise to review insurance appeals, prospective and retrospective claims, and provide an interpretation of the medical necessity of services...

HEDIS Review Nurse Job DescriptionThis is a contracted position that will involve remote work. As a Registered Nurse (RN) or Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) with an unrestricted license in the state, you will be responsible for annual patient chart inspection/audit. The audits are conducted to ensure that providers (MDs)...

Utilization Review Registered Nurse - REMOTEPosition Overview:The Utilization Review Registered Nurse plays a pivotal role in ensuring the appropriate medical necessity documentation for inpatient admissions or observation placements. This position requires effective communication with physicians and clinical staff to guarantee timely submission of clinical...

Utilization Review Registered Nurse - REMOTEPosition Overview:The Utilization Review Registered Nurse is responsible for ensuring the documentation of medical necessity for inpatient admissions or observation placements. This role involves effective communication with physicians and healthcare providers to guarantee timely submission of clinical information...

Position OverviewJob Summary: The Clinical Research Assistant plays a crucial role in supporting clinical studies by ensuring compliance with protocols and maintaining high standards of patient interaction.Key Responsibilities:1) Adhere to all organizational policies and ethical guidelines.2) Maintain strict confidentiality and compliance with regulatory...

Utilization Review Registered Nurse - REMOTEPosition Overview:The Utilization Review Registered Nurse is responsible for ensuring that appropriate medical necessity documentation is maintained for inpatient status or observation placements. This role involves effective communication with physicians and healthcare providers to ensure timely submission of...

Job SummaryWe are seeking a highly skilled Registered Nurse to join our team as a Utilization Review Specialist. In this role, you will be responsible for conducting medical certification reviews to determine the medical necessity of acute care services.Key ResponsibilitiesConduct inpatient admission reviews for Medicare and Medicaid beneficiaries, as well...

Job OverviewPosition Summary: The Clinical Research Assistant plays a crucial role in supporting clinical trials and ensuring compliance with study protocols.Key Responsibilities:1) Adhere to all organizational policies and ethical standards.2) Maintain confidentiality and compliance with regulations.3) Engage professionally with study participants.4) Gather...

Position OverviewJob Summary: The Clinical Research Assistant plays a vital role in the execution of clinical trials, ensuring adherence to protocols and regulatory standards.Key Responsibilities:1) Uphold all organizational policies and ethical standards.2) Maintain strict confidentiality and compliance with all regulations.3) Engage effectively and...

Utilization Review Registered Nurse - REMOTEPosition Overview:The Care Manager is accountable for ensuring the documentation of medical necessity for inpatient admissions or observation placements is accurate and timely. This role involves effective communication with physicians and clinical staff to facilitate the authorization process with payors.Key...

Position Overview at Steward Health CareThe Clinical Care Manager is primarily accountable for documenting the medical necessity for inpatient admissions or observation placements. This role involves close collaboration with physicians and healthcare providers to ensure that clinical data is swiftly communicated to payers for patient authorization during...

Clinical Nurse II The Clinical Nurse II is responsible for delivering comprehensive health evaluations and assessment services, initiating treatments and immunizations according to established protocols, and providing essential education and counseling to patients and healthcare professionals. Key responsibilities include:Gathering medical histories and...

Clinical Research Nurse - Magnet Program and Research Department Why University of Texas Southwestern Medical Center?With a legacy of over 75 years in the Dallas-Fort Worth area, the University of Texas Southwestern Medical Center is dedicated to excellence, innovation, collaboration, and compassion. We prioritize your growth by offering career advancement...

Job Title: Clinical Nurse SpecialistAt Eberstein Witherite LLP, we are seeking a highly skilled Clinical Nurse Specialist to join our team. As a key member of our staff, you will play a vital role in providing exceptional patient care and support.Key Responsibilities:Assist in the implementation of clinical models and systems to ensure high-quality patient...

Job Title & Specialty Area:Clinical Research NurseDepartment:Clinical ResearchLocation:DallasShift:DayJob Type:This position is onsite with the ability to work some days remote based on department needsAbout the Role:The Clinical Research Nurse performs an essential role supporting the principal investigator in the conduct of clinical trials to ensure...

Clinical Nurse IIConduct health evaluations, assessment services, and initiate treatments in accordance with established protocols.Deliver education and counseling to patients and healthcare professionals.Gather medical histories, perform comprehensive physical assessments, and administer necessary treatments.Facilitate educational counseling sessions for...

About the RoleWe are seeking a highly skilled Clinical Research Nurse to join our team at Children's Health. As a Clinical Research Nurse, you will play a critical role in supporting the principal investigator in the conduct of clinical trials, ensuring compliance with all aspects of the protocol and accuracy of data collection.Key...