Clinical Reviewer

Job Title: Clinical ReviewerWe are seeking a skilled Clinical Reviewer to join our team at Wellcove. As a Clinical Reviewer, you will play a critical role in ensuring the accuracy and quality of assessments conducted for Long-Term Care Insurance policyholders.Job Summary:The Clinical Reviewer will be responsible for reviewing completed cognitive and...

R1 RCM is a leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups.We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing...

At St. Luke's Health System, we're committed to delivering exceptional patient experiences. As a Clinical Review Nurse, you'll play a critical role in evaluating medical necessity for patient hospitalization and acting as an internal resource for patient care.Key Responsibilities:Evaluate medical necessity for patient hospitalizationAct as an internal...

R1 RCM is seeking a skilled Clinical Advisor to join our team. As a Clinical Advisor, you will play a critical role in reviewing payor peer-to-peer cases and ensuring compliance with regulatory requirements.Key responsibilities include:Reviewing cases for authorization and evaluating documentation for admission status, procedure, and care settingAdvising...

R1 RCM is seeking a skilled Clinical Advisor to join our team. As a Clinical Advisor, you will play a critical role in reviewing payor peer-to-peer cases and ensuring compliance with regulatory requirements.Key responsibilities include:Reviewing cases for authorization and evaluating documentation for admission status, procedure, and care settingAdvising...

Job SummaryR1 RCM is seeking a skilled Clinical Revenue Cycle Specialist to join our team. As a Physician Advisor, you will play a critical role in reviewing payor peer-to-peer cases and advising clients on the appropriateness of requests based on available documentation.Key ResponsibilitiesReview cases for which authorization has been denied and evaluate if...

Job SummaryPacificSource is seeking a highly skilled Clinical Pharmacist to join our Pharmacy Services team. As a key member of our team, you will be responsible for participating in all day-to-day aspects of the Pharmacy Services Department, including issuance of pharmacy coverage decisions, development of policies and procedures, and coordination of...

PacificSource Clinical Pharmacist Job DescriptionThis role is an excellent opportunity for a Clinical Pharmacist to join PacificSource and contribute to the delivery of high-quality pharmacy services to our members.Key Responsibilities:Provide drug coverage determinations for members with PacificSource Health Plans.Communicate effectively with members,...

Job SummaryThis role is responsible for providing clinical support to account and sales specific activities within the Clinical Services division. The incumbent will work closely with leaders in clinical services and sales/account management to develop collaborative relationships across departments such as sales, actuary, product, and marketing.Key...

Job SummaryThis role is responsible for providing clinical support to account and sales activities within the Clinical Services division. The incumbent will work closely with leaders in clinical services and sales/account management to develop collaborative relationships across departments, providing clinical content research, expertise, and support for...

About the RoleCambia Health is seeking a skilled Utilization Management Nurse to join our Clinical Services team. As a key member of our team, you will play a critical role in ensuring that our members receive the highest quality care while promoting cost-effective outcomes.Key ResponsibilitiesConduct thorough utilization management reviews to ensure medical...

R1 RCM is seeking a highly skilled Clinical Appeals Nurse to join our team. As a Clinical Appeals Nurse, you will play a critical role in ensuring that our hospital clients receive fair and timely reimbursement for their services.Key Responsibilities:Conduct thorough reviews of patient medical records and payer denial information to assess the entire...

R1 RCM is a leading provider of technology-driven solutions that transform the patient experience and financial performance of hospitals, health systems, and medical groups.We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing...

Job Summary:We are seeking a skilled Clinical Laboratory Scientist to join our team at Trinity Health. As a key member of our laboratory team, you will be responsible for performing tests related to the diagnosis and treatment of patients. Your expertise will be essential in utilizing various medical laboratory procedures to ensure accurate and timely...

About AdvantmedAdvantmed is a leading provider of risk adjustment, quality improvement, and value-based solutions to health plans and providers.We drive market-leading performance with integrated technology, service, and program solutions that optimize the risk and quality performance of our partners.Our solutions focus on identifying, managing, and...

Transform Patient Care with Edwards LifesciencesImagine how your expertise can change a patient's life. At Edwards Lifesciences, we generate extensive clinical evidence to demonstrate the effectiveness and safety of our innovations and how our products transform patients' lives.As part of our Clinical Affairs team, you'll hone your scientific curiosity and...

Job Summary:As a Clinical Laboratory Scientist with Trinity Health, you will play a vital role in the diagnosis and treatment of patients by performing various medical laboratory procedures in the Clinical Laboratory. You will correlate and integrate other patient data when interpreting test results, ensuring accurate and timely delivery of results to...

Adecco Healthcare & Life Sciences is seeking a Licensed Practical Nurse for a non-clinical role at one of our clients in the Boise area.This opportunity offers a healthy work-life balance and a fun environment.Job Requirements:To be considered, you must have:Unencumbered LPN licensure (newly licensed nurses are encouraged to apply)Flexibility and ability to...

Job SummaryWe are seeking a Medical Assistant to join our Outpatient Behavioral Health Clinic team. As a Medical Assistant, you will work closely with a cohesive team in a fast-paced and enjoyable environment. You will be responsible for rooming patients, taking vital signs, and preparing and administering injections. You will also review medication...

Job Summary:We are seeking a Medical Assistant to join our team at the Outpatient Behavioral Health Clinic. As a Medical Assistant, you will work closely with a cohesive team in a fast-paced and enjoyable environment. You will be responsible for rooming patients, taking vital signs, and preparing and administering injections. You will also review medication...