Clinical Utilization Management Specialist

Job Title: Clinical Utilization Management SpecialistLocation: Flexible work arrangements availableJob Summary:We are seeking a skilled Clinical Utilization Management Specialist to join our team at Medix. As a key member of our IDR team, you will be responsible for conducting reviews up to and including the appeal level, compiling regulatory guidance,...

Job Title: Utilization Management SpecialistLocation: Flexible work arrangements available, with the option to work in the office or remotely.Hours: Monday to Friday, 8am to 5pm.Pay: Competitive hourly rate, with opportunities for negotiation.Job Description:We are seeking an experienced Utilization Management Specialist to join our team at Medix. In this...

Job OpportunityGreenlife Healthcare Staffing is seeking a skilled Registered Nurse Clinical Reviewer to join their team.Responsibilities:Conduct thorough reviews of medical records, including chart screens, regulatory guidance, and insurer requirements.Prepare final determinations and provide technical assistance to administrative and clinical...

Job SummaryCVS Health is seeking a skilled Clinical Utilization Specialist to join our team. As a key member of our utilization management team, you will play a critical role in coordinating and documenting all aspects of the utilization/benefit management program for preauthorization of mental health services.Key Responsibilities- Utilize clinical skills to...

Job Title: Utilization Management / Appeals Registered Nurse Job Details Posting Date: 10/21/2024 Reference ID: 235039 Locations: Openings in both Lake Success (New Hyde Park), NY or Albany, NY Work Location: Onsite Discipline: Nursing / Utilization Management Job Type: Contract-to-hire Salary Expectations: $50 - $54/hour Schedule/Shift: Monday to Friday,...

Job Title: Clinical Appeals SpecialistLocation:Flexible work arrangements available, with a preference for nurses to work in the office in either Lake Success (New Hyde Park) or Albany, NYHours:Monday to Friday, 8am to 5pmStart date:As soon as possible, with a focus on getting all RNs started togetherPay:$48-52 per hour, with opportunities for...

Clinical Opportunities with Greenlife Healthcare Staffing **Job Title:** Clinical Nurse Specialist - Wound Care Reviewer **Job Summary:** Greenlife Healthcare Staffing is seeking a Clinical Nurse Specialist - Wound Care Reviewer to join our team. As a Clinical Nurse Specialist, you will be responsible for reviewing cases and providing expert opinions on...

Job Title: Clinical Assessment RN ManagerFlexStaff Careers is seeking an experienced and motivated Clinical Assessment RN Manager to lead our clinical assessment team and ensure the efficient and timely completion of all tasks associated with the clinical assessment process.Key Responsibilities:Conduct in-home or virtual clinical assessments using UAS-NY for...

Job Title: Clinical Assessment RN ManagerJob Summary:FlexStaff Careers is seeking an experienced and motivated Clinical Assessment RN Manager to lead our clinical assessment team and ensure the efficient and timely completion of all tasks associated with the clinical assessment process.Key Responsibilities:Conduct in-home or virtual clinical assessments...

Job SummaryClinical Coding Auditor - Coding Specialist at Northwell HealthJob DescriptionClinical Coding Auditors play a crucial role in optimizing diagnosis-related groupings and ensuring accurate coding practices. As a Clinical Coding Auditor - Coding Specialist, you will be responsible for conducting coding audits, developing and implementing coding...

Job SummaryWe are seeking a skilled Diagnostic Imaging Specialist to join our team at SB Clinical Practice Management. The ideal candidate will have a strong background in radiology and the ability to work efficiently in a fast-paced environment.Key ResponsibilitiesPerform high-quality diagnostic radiological procedures using fluoroscopy equipment.Ensure...

Job SummaryWe are seeking a skilled Clinical Engineering Technician to join our team at Northwell Health. The successful candidate will be responsible for performing repairs and maintenance of patient and non-patient care equipment, as well as providing technical assistance to equipment users and junior members of the department.Key ResponsibilitiesPerform...

Clinical Reviewer Job DescriptionIPRO is seeking a skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will be responsible for conducting full-spectrum activities related to utilization or quality reviews as assigned.You will utilize your knowledge and expertise of the review program to conduct clinical-level reviews, supporting Medical...

Job Description FlexStaff Our client is seeking an experienced and motivated Clinical Assessment RN Manager to lead our clinical assessment team and ensure the efficient and timely completion of all tasks associated with the clinical assessment process. The ideal candidate will play a key role in managing the onboarding and reassessment of participants,...

Job DescriptionAn exciting opportunity for a Clinical Supervisor of Inpatient Dietary Services position is now open at an award winning Hospital located in Portland! As the Clinical Supervisor of Inpatient Dietary Services, you will assume a pivotal role within an organization renowned for its steadfast dedication to quality care and safety. Equipped with...

About the Role:Cambia is seeking a skilled Utilization Management Nurse to join our Clinical Services team. As a Utilization Management Nurse, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care possible.Key Responsibilities:Conduct utilization management reviews to ensure medical necessity and...

Job Title: Utilization Management Nurse SpecialistJob Summary:Myriad Genetics, Inc. is seeking a skilled Utilization Management Nurse Specialist to join our team. This role will be responsible for leading and performing individual work on appeals for erroneous denials and obtaining patient chart notes. The successful candidate will have a strong background...

Clinical Reviewer Job DescriptionAt IPRO, we are seeking a highly skilled Clinical Reviewer to join our team. As a Clinical Reviewer, you will play a critical role in ensuring the accuracy and appropriateness of our review process.Key Responsibilities:Conduct utilization reviews up to and including the appeal level, including chart screen, electronic...

FlexStaff Careers is seeking a seasoned professional to fill the role of Director of Operations for our esteemed client, a leading manufacturer of cutting-edge electronics devices for military, aerospace, and commercial use.The ideal candidate will oversee the development and evaluation of manufacturing processes, utilizing advanced product design,...

Job Title: Wound Care SpecialistJob Summary: Greenlife Healthcare Staffing is seeking a Wound Care Specialist to fill an opening with a Non-profit organization. The ideal candidate will have a minimum of 5 years active clinical practice within the specialty and 2 years of recent experience.Responsibilities:Audit and review cases to ensure standard of care is...