Current jobs related to Clinical Reviewer - New York, New York - Greenlife Healthcare Staffing
-
Clinical Reviewer
4 weeks ago
New York, New York, United States Greenlife Healthcare Staffing Full timeJob Title: Clinical ReviewerJob Description:We are seeking a skilled Clinical Reviewer to join our team at Greenlife Healthcare Staffing. As a Clinical Reviewer, you will be responsible for conducting utilization reviews up to and including the appeal level. This includes chart screen, completing electronic worksheets, entering the required information, and...
-
Clinical Review Specialist
4 weeks ago
New York, New York, United States Dane Street Full timeJob Title: Clinical Review SpecialistDane Street is seeking a skilled Clinical Review Specialist to conduct Group Health reviews. This role involves a clinical summary, potential calls to treating providers, and responses to questions posed.Key Responsibilities:Conduct thorough clinical reviews of Group Health casesPrepare and submit high-quality clinical...
-
Clinical Review Specialist
4 weeks ago
New York, New York, United States Dane Street Full timeJob Summary:Dane Street is seeking a skilled Clinical Review Specialist to conduct Group Health reviews. This role involves a clinical summary, potential calls to treating providers, and responses to questions posed.Key Responsibilities:Conduct thorough clinical reviews of Group Health casesPrepare clinical summaries and potential calls to treating...
-
Clinical Review Specialist
4 weeks ago
New York, New York, United States Dane Street Full timeJob Title: Clinical Review SpecialistDane Street is seeking a skilled Clinical Review Specialist to conduct Group Health reviews. This role involves a clinical summary, potential calls to treating providers, and responses to questions posed.Key Responsibilities:Conduct thorough clinical reviews of patient casesCommunicate with treating providers to gather...
-
Clinical Review Specialist
4 weeks ago
New York, New York, United States Infojini Full timeKey Responsibilities:As a Clinical Review Specialist at Infojini, you will utilize your clinical knowledge to review medical charts for accuracy and sequencing of diagnosis. This involves analyzing Consultation reports, History and Physical reports, Operative reports, Progress reports, and Discharge reports, including complex cases. Required Skills: Epic...
-
Clinical Pharmacist
1 month ago
New York, New York, United States Health First Full timeJob SummaryWe are seeking a highly skilled Clinical Pharmacist to join our team as a UM Reviewer. As a key member of our Utilization Management team, you will be responsible for reviewing and approving medication requests, ensuring compliance with regulatory requirements, and developing clinical criteria and medical policies.Key ResponsibilitiesReview and...
-
Clinical Review Nurse Specialist
3 days ago
New York, New York, United States Medix Full timeClinical Review Nurse Role OverviewAt Medix, we are seeking a skilled Clinical Review Nurse to join our team. The successful candidate will act as a liaison between participants and providers, ensuring compliance with regulatory and contractual requirements.Key ResponsibilitiesReview and process service authorization requests from providers in a timely and...
-
Physician Reviewer
4 weeks ago
New York, New York, United States Dane Street Full timeJob Title: Physician Reviewer - Clinical Summary SpecialistAbout the Role:Dane Street is seeking skilled Physician Reviewers to conduct Group Health reviews. As a Clinical Summary Specialist, you will be responsible for creating a comprehensive clinical summary, identifying potential calls to treating providers, and responding to questions posed.Key...
-
Clinical Utilization Review Specialist
4 weeks ago
New York, New York, United States Dane Street Full timeDane Street, a certified "Great Place to Work" company, is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized...
-
Clinical Auditor
4 weeks ago
New York, New York, United States MedReview Full timeJob OverviewMedReview is seeking a highly motivated and experienced Registered Nurse Auditor to join our Hospital Bill Review Department. As a key member of our team, you will be responsible for performing bill reviews and chart validations to ensure accuracy and accountability in healthcare payment integrity.Key ResponsibilitiesConduct thorough bill reviews...
-
Clinical Review Specialist: Neurological Surgery
4 weeks ago
New York, New York, United States Dane Street Full timeThis telework opportunity at Dane Street provides the ability to customize your schedule and caseload within the week while maintaining client-mandated turnaround times.Our reviewers are compensated on a per-case basis as a 1099 independent contractor.Preferred candidates will hold a NY License, and be NY WC Board Certified.JOB SUMMARYAs a Clinical Review...
-
Clinical Auditor
1 month ago
New York, New York, United States MedReview LLC Full timeJob Title: Clinical Auditor - Hospital Bill ReviewsMedReview LLC is seeking a highly motivated and experienced Registered Nurse to join our Hospital Bill Review Department as a Clinical Auditor. In this role, you will be responsible for performing bill reviews and chart validations to ensure accuracy and accountability in healthcare.Key...
-
Clinical UM Pharmacist
4 weeks ago
New York, New York, United States Health First Full timeJob SummaryHealth First is seeking a skilled Clinical UM Pharmacist to join our team. As a key member of our Utilization Management department, you will play a critical role in ensuring the efficient and effective review of medication requests.Key Responsibilities Monitor and review prior authorization requests for medications to ensure compliance with...
-
Clinical Quality Reviewer
4 weeks ago
New York, New York, United States Innova Solutions Full timeClinical Quality Reviewer Job DescriptionInnova Solutions is seeking a highly skilled Clinical Quality Reviewer to join our team. As a Clinical Quality Reviewer, you will be responsible for assessing and auditing medical charts for compliance with HEDIS, QARR, Medicare Advantage Star measures, and quality improvement activities.Key Responsibilities:Maintain...
-
Clinical Review Nurse
4 weeks ago
West New York, New Jersey, United States VNS Health Full timeVNS Health is seeking a skilled Clinical Review Nurse to join their team. As a Utilization Review RN, you will be responsible for conducting clinical assessments, including medication reconciliations and post-discharge transitions of care assessment. You will also collaborate with programs to ensure compliance with regulatory requirements, lead and...
-
Utilization Review Coordinator
4 weeks ago
New York, New York, United States StateJobsNY Full timeJob SummaryNew York State Psychiatric Institute is seeking a Utilization Review Coordinator to analyze and evaluate the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Candidates from outside or within State Service can apply for this position under the Hiring for Emergency...
-
Medical Review Specialist
4 weeks ago
New York, New York, United States Concentra Full timeMedical Review SpecialistWe are seeking a highly skilled Medical Review Specialist to join our team at Concentra. As a Medical Review Specialist, you will be responsible for reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, and appropriateness of care.Key Responsibilities:Reviews medical files and...
-
Dental Hygienist Reviewer Position
4 weeks ago
New York, New York, United States GreenLife Healthcare Staffing Full timeDental Hygienist Reviewer Job DescriptionWe are seeking a skilled Dental Hygienist Reviewer to join our team at Greenlife Healthcare Staffing. As a Dental Hygienist Reviewer, you will be responsible for reviewing patient records, conducting site observations, and making recommendations to improve clinical services.Key Responsibilities:Conduct thorough...
-
Physician Utilization Reviewer
4 weeks ago
New York, New York, United States Dane Street Full timeDane Street is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized evidence-based guidelines, and client-specific...
-
Dental Hygienist Reviewer Position
4 weeks ago
New York, New York, United States GreenLife Healthcare Staffing Full timeAbout the Role:We are seeking a skilled Dental Hygienist to fill a part-time position with a non-profit organization in Upstate, New York. The successful candidate will be responsible for reviewing clinical services and making recommendations to improve quality.Key Responsibilities:Completes pre-review activities, including scheduling and review of previous...
Clinical Reviewer
1 month ago
Greenlife Healthcare Staffing is seeking a skilled Registered Nurse Clinical Reviewer to join our team.
Job Summary:
We are looking for a highly motivated and detail-oriented Registered Nurse Clinical Reviewer to conduct utilization reviews, quality and clinical study data collection reviews, and provide technical assistance to administrative staff.
Responsibilities:
- Conduct utilization reviews up to and including the appeal level, including chart screen, electronic worksheets, and making level one denial decisions when necessary.
- Conduct quality and clinical study data collection reviews, including chart review and detailed electronic data worksheets.
- Act as a resource for administrative staff in training, problem-solving, and clarifying procedures.
- Participate in collaborative training specific to clinical study objectives.
- Other activities as may be deemed necessary.
Requirements:
- Active RN State license.
- 1-3 years of experience in acute care utilization review/appeals background.
- Comfortable working on a computer, familiar with Outlook, spreadsheets, and Word.
Benefits:
- $45 - $50 / hr salary.
- 2 weeks vacation.
- Major holidays.
- 5 sick days.
- License reimbursement.
Schedule:
- Full-time position.
- Remote position.
- Monday to Friday (9:00 AM-5:30 PM).
Greenlife Healthcare Staffing is a nationwide recruitment agency, matching both new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
