Clinical Reviewer

Job SummaryWe are seeking a highly skilled Clinical Reviewer to join our team at Independent Health Association. As a Clinical Reviewer, you will be responsible for the collection and review of medical records specific to quality complaints/grievances and appeals.Key ResponsibilitiesInvestigate quality complaints/grievances and appeals, document research of...

Unlock Your PotentialWe're committed to fostering a culture of growth and inclusion. As a Utilization Review Nurse at Independent Health, you'll have the opportunity to develop your skills and expertise in a dynamic and supportive environment.About the RoleThe Utilization Review Nurse performs clinical reviews to determine the medical necessity of requested...

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Independent Health Association. As a Utilization Review Nurse, you will play a critical role in ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesPerform clinical reviews to determine the medical necessity of requested servicesObtain and...

Job SummaryWe are seeking a skilled Clinical Review Nurse to join our team at Independent Health. As a Utilization Review Nurse, you will play a critical role in determining the medical necessity of requested services.Key Responsibilities Perform clinical reviews to determine medical necessity of requested services Obtain clinical information and utilize...

Unlock Your PotentialWe're seeking a skilled Utilization Review Nurse to join our team at Independent Health. As a Utilization Review Nurse, you will play a critical role in ensuring that our members receive the necessary care and services to achieve optimal health outcomes.About the RoleThe Utilization Review Nurse will be responsible for performing...

Job Title: Utilization Review CoordinatorBuffalo Psychiatric Center is seeking a skilled Utilization Review Coordinator to analyze and evaluate the quality, effectiveness, and efficiency of psychiatric and medical services provided to individuals diagnosed with mental illness.Responsibilities:Review clinical records for completeness and accuracy to ensure...

Job SummaryThis role is responsible for conducting in-house utilization review with a focus on determining medical necessity for prospective, concurrent, retrospective, and appeal treatment requests for workers' compensation claims.Key ResponsibilitiesInterpret routine, complex, or unique medical information to evaluate medical treatment and determine...

Job SummaryWe are seeking a skilled Utilization Review Nurse to join our team at Travelers Insurance. As a Medical Case Manager, you will play a critical role in ensuring that our customers receive the necessary medical treatment for their workers' compensation claims.Key ResponsibilitiesConduct in-house utilization review to determine medical necessity for...

Clinical Pharmacist Consultant Position OverviewThe Clinical Pharmacist Consultant is responsible for evaluating and reporting on patient medication regimens to ensure appropriateness, effectiveness, and safety. This involves considering quality of life, adverse issues, cost, and regulatory compliance.Key ResponsibilitiesSupport the Director of Clinical...

Job SummaryWe are seeking a highly skilled Utilization Review Nurse to join our team at Travelers Insurance. As a Utilization Review Nurse, you will play a critical role in ensuring that medical treatment is necessary and reasonable for workers' compensation claims.Key ResponsibilitiesConduct in-house utilization review to determine medical necessity for...

Job SummaryAs a Clinical Laboratory Technologist at Catholic Health System, you will play a critical role in implementing the section's objectives, ensuring quality control, and maintaining effective communication. Key Responsibilities:•⁠ ⁠Implement the section's objectives, quality control, and communication. •⁠ ⁠Familiarize yourself with...

Job SummaryTravelers Insurance is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for conducting in-house utilization review with emphasis on determining medical necessity for prospective, concurrent, retrospective and appeal treatment requests for workers compensation claims.Key...

Job Summary:As a Clinical Laboratory Technologist Micro, you will play a vital role in the implementation of the section's objectives, quality control, and communication in our clinical microbiology laboratory. Your primary responsibility will be to ensure the accurate identification and analysis of microorganisms in clinical specimens. You will also be...

Job Summary:AltaStaff is hiring a Clinical Assessment Specialist to review consumer assessments for long term care services and supports in New York State. The ideal candidate will have 2+ years of practicing experience as a Nurse Practitioner and excellent clinical and communication skills.Responsibilities:Review and make recommendations on consumer...

Quality Clinical Documentation SpecialistAt Kaleida Health, we are seeking a highly skilled Clinical Documentation Specialist to join our team. As a key member of our clinical documentation team, you will play a critical role in ensuring the accuracy and completeness of patient records.Key Responsibilities:Conduct concurrent analytical reviews of clinical...

Clinical Pharmacist Consultant Job DescriptionWe are seeking a highly skilled Clinical Pharmacist Consultant to join our team at Elderwood. As a Clinical Pharmacist Consultant, you will play a critical role in ensuring the quality and safety of patient care.Key Responsibilities:Evaluate and report on patient medication regimens to ensure appropriateness,...

Job Summary: We are seeking a Clinical Research Budget/Compliance Specialist to join our team at Roswell Park Cancer Institute. The successful candidate will be responsible for conducting Medicare Coverage Analysis (MCA) for Roswell Park clinical research studies to ensure compliance with Medicare regulations. This role will also involve developing a...

Job SummaryThe Ambulatory Clinical Documentation Improvement Specialist plays a crucial role in ensuring the accuracy and completeness of clinical documentation in our ambulatory settings. This position is responsible for reviewing and improving the quality of clinical documentation to support revenue capture and compliance.Key ResponsibilitiesAssist...

Quality Clinical Documentation SpecialistAbout the RoleThe Quality Clinical Documentation Specialist plays a critical role in promoting accurate and meaningful clinical documentation that reflects the resources used in patient care. This position collaborates extensively with the clinical team, HIM coding team, nursing, patient management, quality...

Job SummaryClinical care delivery and performance management in the market in collaborative partnership with the Market Operations Leader is the responsibility of the Medical Director. This role involves support and oversight of clinical care delivered by field-based clinical practitioners, data-driven and KPI-directed clinical performance management, direct...