Clinical Utilization Review Specialist

Job SummaryAlto Pharmacy is seeking a highly skilled and motivated Production Pharmacist to join our team. As a key member of our operations team, you will be responsible for providing comprehensive and accurate clinical utilization review and dispensing services.Key ResponsibilitiesReview and verify the accuracy of drug packaging and labelingConduct...

Job SummaryWe are seeking a skilled Utilization Management Review Nurse LVN to join our team at Santa Clara County 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 ensure...

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...

Job SummaryAurora San Diego is seeking a skilled Utilization Review Specialist to join our team. As a key member of our multi-disciplinary treatment team, you will play a critical role in reviewing patient care and treatment options for both inpatient and outpatient services.Key Responsibilities:Conduct admission reviews to ensure accurate and efficient...

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...

Job SummaryAurora San Diego is seeking a skilled Utilization Review Specialist to join our team. As a key member of our multi-disciplinary treatment team, you will play a critical role in reviewing patient care and treatment options for both inpatient and outpatient services.Key Responsibilities:Conduct admission reviews to ensure accurate and efficient...

Medical Claims Review OpportunityMedical Review Institute of America (MRIoA) is seeking licensed physicians to join our esteemed peer review panel. As a Medical Claims Review Specialist, you will conduct independent, impartial reviews of medical documentation to ensure services provided align with recognized standards of care and current medical...

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...

Job SummaryWe are seeking a highly skilled Utilization Review Coordinator to join our team at the County of Santa Clara CA. As a Utilization Review Coordinator, you will play a critical role in reviewing and monitoring the utilization of hospital services to ensure compliance with federal, state, and county regulations.Key ResponsibilitiesMonitor admissions...

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 Title: Travel Registered Nurse - Utilization Review SpecialistHealthcare Staffing Plus is seeking a skilled Travel Registered Nurse - Utilization Review Specialist to join our team. As a Utilization Review Nurse, you will play a critical role in developing and maintaining policies and procedures for utilization management.Key Responsibilities:Collaborate...

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 SummaryWe are seeking a skilled Utilization Management Review Nurse LVN to join our team at Santa Clara County 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 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 SummaryAurora San Diego seeks a skilled Utilization Review-Case Management professional to join our team. As a key member of our multi-disciplinary treatment team, you will play a critical role in reviewing patient care and treatment options for both inpatient and outpatient services.Key Responsibilities:Conduct admission reviews to ensure optimal...