Clinical Utilization Review Specialist

Product Review Specialist OpportunityAt Product Review Jobs, we are seeking a Product Review Specialist to participate in market research opportunities with independent brands. As a Product Review Specialist, you will be responsible for completing online or phone studies to provide valuable feedback on various products.Key Responsibilities:Complete online or...

Job Title: Healthcare Utilization Review SpecialistCare Review Clinician, Prior Authorization (Registered Nurse, or LVN)Key Responsibilities:Conducts prior authorization reviews to determine financial responsibility for Molina Healthcare and its members.Refers appropriate prior authorization requests to Medical Directors.Collaborates with multidisciplinary...

Product Review Specialist OpportunityAt Product Review Jobs, we are seeking a Product Review Specialist to participate in market research opportunities with independent brands. As a Product Review Specialist, you will be responsible for completing online or phone studies to provide valuable feedback on various products.Key Responsibilities:Complete online or...

Product Review SpecialistAt Product Review Jobs, we are seeking a skilled Product Review Specialist to participate in market research opportunities with independent brands. As a Product Review Specialist, you will be responsible for completing online or phone studies to provide valuable feedback on various products. Compensation varies per study, with some...

Job DescriptionAurora San Diego seeks a skilled Utilization Review Specialist to join our team. In this role, you will work as a member of a multi-disciplinary treatment team, reviewing patient care and treatment options for both inpatient and outpatient services.Key Responsibilities:Conduct admission reviews to ensure patients receive appropriate...

Compensation: Varies per assignment, up to $500 per week.Location: Remote (USA)Company: ProductReviewJobsAs a Product Review Specialist, you will participate in market research opportunities with independent brands via online or phone. These studies typically take 15 minutes, while telephone interviews may take 30-60 minutes each session. Compensation varies...

Product Review SpecialistAre you interested in participating in market research opportunities with independent brands? As a Product Review Specialist with Product Review Jobs, you will have the chance to complete online studies and telephone interviews to provide valuable feedback on various products. Compensation varies per study, and you will be required...

Product Review SpecialistAs a Product Review Specialist with Product Review Jobs, you will have the opportunity to participate in market research studies for various independent brands. These studies are conducted online or via phone and typically take 15 minutes to an hour to complete. Compensation varies per study, but some studies can pay up to $500 per...

Job DescriptionMedRisk is seeking a skilled Clinical Reviewer to join our team in the utilization review program. As a Clinical Reviewer, you will play a critical role in promoting quality outcomes and enhancing the physical, psychosocial, and vocational health of individuals.Key Responsibilities:Evaluate medical data for utilization review requests and...

Job Summary:We are seeking a skilled Nurse Specialist to join our team at St. Elizabeth's Medical Center. As a key member of our Clinical Review team, you will be responsible for reviewing Client Development Evaluation Reports (CDER) of Diagnostic Elements and coding medical conditions. Your expertise will help us provide high-quality care to our...

Job SummaryThe Utilization Management Review Nurse LVN is responsible for conducting clinical reviews to ensure effective and appropriate utilization of benefits and services for prospective, concurrent, and retrospective/claims review organization determination authorization requests within regulatory turnaround requirements for all SCFHP lines of...

Job Title: Travel Nurse - Utilization Review SpecialistJob Summary: We are seeking a skilled Travel Nurse - Utilization Review Specialist to join our team at Healthcare Staffing Plus. As a key member of our healthcare team, you will be responsible for assisting in the development and maintenance of policies and procedures related to utilization management....

Job SummaryWe are seeking a skilled Utilization Management Review Nurse LVN to join our team at Santa Clara Family Health Plan. As a key member of our Health Services department, you will play a critical role in ensuring the effective and appropriate utilization of benefits and services for our members.Key ResponsibilitiesConduct clinical reviews to assess...

Job Title: Travel Registered Nurse - Utilization Review SpecialistJob Summary:We are seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team at Healthcare Staffing Plus. As a Utilization Review Specialist, you will play a critical role in developing and maintaining policies and procedures for the Service Area or Medical...

Job Title: Travel Registered Nurse Utilization Review SpecialistJob Summary:Healthcare Staffing Plus is seeking a skilled Travel Registered Nurse Utilization Review Specialist to join our team. As a Utilization Review Registered Nurse, you will be responsible for assisting in developing and maintaining policies and procedures for the Service Area or Medical...

About MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay, offering a unique blend of academic medicine and personalized care. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the right care at the right time.Job SummaryThe Utilization Review Nurse is responsible...

Job SummaryWe are seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team at Healthcare Staffing Plus. As a key member of our team, you will be responsible for assisting in the development and maintenance of policies and procedures related to utilization management.Key Responsibilities:Collaborate with multi-disciplinary...

About MarinHealth Medical CenterMarinHealth Medical Center is a leading healthcare provider in the North Bay area, offering a comprehensive range of services to meet the diverse needs of our community. We are seeking a highly skilled Utilization Review Nurse to join our team of dedicated healthcare professionals.Job Summary:The Utilization Review Nurse will...

Job SummaryThe Utilization Review Nurse is a key member of the Care Coordination team at Actalent. This role involves coordinating continuing care and outside services for value-based risk members, collaborating with hospitals and primary care physicians to ensure optimal patient outcomes.Responsibilities include:Repatriating stable members from non-member...

Job SummaryThe Utilization Review Nurse is a key member of the Care Coordination team at Actalent, responsible for ensuring the most effective and efficient use of healthcare resources. This role requires a strong understanding of healthcare systems, policies, and procedures, as well as excellent communication and collaboration skills.Key...