Clinical Review Specialist

Job Title - Registered Nurse - Clinical ReviewDuration - 10 monthsLocation - RemotePay: $40.00/hr on W2We are seeking a highly skilled Registered Nurse to join our team as a Clinical Review Specialist. In this role, you will be responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary...

Job SummaryWe are seeking a skilled Clinical Review Specialist to join our team at LanceSoft. In this role, you will be responsible for conducting thorough reviews of inpatient, outpatient, and ambulatory services to ensure medical necessity and appropriate care.Key Responsibilities:Perform prospective, concurrent, and retrospective reviews of healthcare...

Job SummaryWe are seeking a highly skilled Clinical Review Specialist to join our team at LanceSoft. As a key member of our post-acute care review team, you will be responsible for ensuring the medical necessity of services provided to our members.Key Responsibilities:Conduct prospective, concurrent, and retrospective medical necessity reviews of post-acute...

Job Summary:As a Healthcare Review Specialist with w3r Consulting, you will play a critical role in ensuring the quality and appropriateness of healthcare services. You will conduct thorough reviews of inpatient, outpatient, and ambulatory services to verify medical necessity and ensure that care is delivered in a timely and efficient manner.Key...

Job Summary:We are seeking a skilled Clinical Review Nurse to join our team at LanceSoft. As a Clinical Review Nurse, you will play a critical role in ensuring the medical necessity of post-acute care services.Key Responsibilities:Conduct prospective, concurrent, and retrospective medical necessity reviews of post-acute care services to ensure medical...

Genex Service LLC is seeking a skilled Utilization Reviewer to join our team. As a Utilization Reviewer, you will be responsible for performing precertification reviews for New Jersey auto accident PIP medical treatment referrals. You will use your critical thinking and clinical judgment to ensure that treatment is medically necessary and authorized. This is...

Job Title: Prior Authorization NurseJob SummaryActalent is seeking a skilled Clinical Review Nurse to join our team as a Prior Authorization Nurse. In this role, you will be responsible for analyzing prior authorization requests to determine medical necessity and appropriate level of care in accordance with national standards, contractual requirements, and a...

Job Title: Registered Nurse Review AnalystDuration: 10 monthsLocation: RemotePay: $40.00/hr on W2As a Registered Nurse Review Analyst, you will be responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary services to ensure medical necessity, appropriate length of stay, intensity of...

Job Title – Registered Nurse – Review AnalystDuration – 10 monthsLocation – RemotePay: $40.00/hr on W2We are seeking a skilled Registered Nurse to join our team at W3R Consulting. As a Review Analyst, you will be responsible for performing prospective, concurrent, and retrospective reviews of inpatient, outpatient, ambulatory, and ancillary services...

Mobile Research Nurse Job DescriptionWe are seeking a skilled and compassionate nurse with a passion for clinical research to join our dynamic team as a Mobile Research Nurse. As a key member of our team, you will play a crucial role in ensuring the successful execution of research studies.Key Responsibilities:Administer investigational medications/products...

Job SummaryWe are seeking a highly skilled Clinical Pharmacy Specialist to join our team at the Veterans Affairs, Veterans Health Administration. As a Clinical Pharmacy Specialist, you will play a critical role in providing exceptional patient care and contributing to the development of innovative clinical pharmacy services.Key ResponsibilitiesDesign,...

Why Work at OpTech?OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. Our company culture is built on a foundation of respect, empathy, and open communication. When you work at OpTech, you can expect a supportive team environment, opportunities for professional development, and a competitive compensation...

Job OverviewQSS Southeast Clinical Services LLC is seeking a detail-oriented and highly motivated Medical Claims Specialist to join our team.The ideal candidate will have excellent analytical skills and be able to work accurately and efficiently in a fast-paced environment.Responsibilities include reviewing and processing medical claims, ensuring compliance...

Job Title: Clinical Specialist Utilization ManagementAt Detroit Wayne Mental Health Authority, we are seeking a highly skilled Clinical Specialist Utilization Management to join our team. As a key member of our organization, you will play a vital role in ensuring that our consumers receive the highest quality care and services.Job Summary:The Clinical...

Job SummaryWe are seeking a skilled Clinical Care Specialist to join our team at PSG Global Solutions Careers. As a key member of our healthcare team, you will be responsible for reviewing medical necessity for post-acute care services, ensuring that patients receive the appropriate level of care. Your expertise in clinical knowledge and experience in...

Job SummaryWe are seeking a skilled Clinical Care Specialist to join our team at w3r Consulting. The ideal candidate will have a strong background in healthcare and experience in utilization review, case management, and patient care.Key Responsibilities:Review precertification admission and concurrent reviews for the appropriateness of the inpatient setting...

Job Title: Clinical Nurse SpecialistThe Detroit Medical Center is seeking a highly skilled Clinical Nurse Specialist to join our team. As a key member of our nursing staff, you will be responsible for providing exceptional patient care and promoting a culture of excellence within our organization.About the Role:This is a full-time position that requires a...

Job SummaryThis is a general application for a clinical application specialist position that is applicable across all TRA locations and RN and Allied Travel and Local contracts. The selected candidate will receive a customized offer letter for the specific position they are hired into.About TRATRA offers greater contract security than outside agencies while...

Job Summary:As a TRA Case Manager Utilization Review Specialist, you will play a critical role in facilitating care along a continuum through effective resource coordination to help patients achieve optimal health, access to care, and appropriate utilization of resources. This position requires strong negotiation skills to manage medical necessity processes...

Job SummaryQSS Southeast Clinical Services LLC is seeking a skilled Medical Billing and Collections Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and collections of medical claims. Your expertise in medical billing and collections will be crucial in maintaining our...