Clinical Review Specialist

Job Title: Clinical Reviewer - ABA ServicesJoin Centene Corporation, a leading healthcare company, as a Clinical Reviewer - ABA Services. In this role, you will be responsible for reviewing member care and health status to determine medical appropriateness of Applied Behavioral Analysis (ABA) services.Key Responsibilities:Evaluate member care and health...

Job Title: Environmental Review Compliance SpecialistICF is seeking an Environmental Review Compliance Specialist to help manage federal grants to recover from disasters and conduct strategic and high-impact activities to mitigate disaster risks and reduce future losses in communities.Key Responsibilities:Assist with program compliance with U.S. Department...

Job Title: Clinical Review SpecialistJoin Centene Corporation, a leading healthcare company, as a Clinical Review Specialist. In this role, you will play a critical part in ensuring the quality and appropriateness of mental health and substance abuse services for our 28 million members.Key Responsibilities:Evaluate member treatment plans for mental health...

Job Title: Clinical Review NurseJoin Centene Corporation, a leading healthcare company, as a Clinical Review Nurse and play a vital role in shaping the future of healthcare.About the Role:We are seeking a highly skilled and experienced Clinical Review Nurse to join our Medical Management/Health Services team. As a Clinical Review Nurse, you will be...

Job Title: Utilization Review ClinicianJoin our team at Centene Corporation as a Utilization Review Clinician and make a meaningful impact on the lives of our 28 million members.Job Summary:We are seeking a highly skilled and experienced Utilization Review Clinician to join our Medical Management/Health Services team. As a key member of our team, you will be...

Job Title: Utilization Review Clinician - ABAJoin Centene Corporation, a leading healthcare company, as a Utilization Review Clinician - ABA. In this role, you will play a critical part in ensuring the medical appropriateness of Applied Behavioral Analysis (ABA) services for our members.Key Responsibilities:Evaluate member care and health status before,...

Job SummaryWe are seeking a highly skilled Licensed Utilization Review Specialist to join our team at Elevance Health. As a key member of our medical management team, you will play a critical role in ensuring that our members receive the most appropriate and cost-effective care possible.Key ResponsibilitiesConduct thorough reviews of medical necessity and...

Job Title: Analytical Data Review SpecialistWe are seeking a highly skilled Analytical Data Review Specialist to join our team at PL Developments. As an Analytical Data Review Specialist, you will be responsible for reviewing and ensuring the accuracy of analytical data for pharmaceutical products.Key Responsibilities:Finalize the review of analytical data,...

Job SummaryWe are seeking a highly skilled Clinical Pharmacist to join our Medical Management/Health Services team. As a Clinical Pharmacist, you will play a critical role in ensuring our members receive the most effective and cost-effective pharmacological therapies.Key ResponsibilitiesProcess prior authorization requests for non-formulary medications for...

Job Title: Medicaid Management Review MonitorAgency Overview:The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity. Our mission is to provide better healthcare for all Floridians.Job Summary:We are seeking a Medicaid Management Review Monitor to join our team. This role will be responsible for monitoring...

Medicaid Management Review MonitorAgency Overview:The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, and empowering consumers through health care transparency...

Job Title: Nurse ReviewerMedRisk is seeking a skilled Nurse Reviewer to join our team in our utilization review program. As a Nurse Reviewer, you will play a critical role in promoting quality outcomes and enhancing the physical, psychosocial, and vocational health of individuals.Job Summary:The Nurse Reviewer will apply technical knowledge and experience to...

Job Title: Authorization Specialist IIJoin Centene Corporation, a leading healthcare company, as an Authorization Specialist II. In this role, you will play a critical part in ensuring that our 28 million members receive timely and accurate authorization for their healthcare services.Job Summary:The Authorization Specialist II will serve as a resource and...

Clinical Research Opportunity in PsychiatryWe are seeking a highly motivated and detail-oriented individual to join our team as a Clinical Research Specialist in Psychiatry. As a Clinical Research Specialist, you will be responsible for coordinating and managing clinical trials, working closely with investigators, research coordinators, and other team...

Job Title: Institutional Review Board Post Approval Compliance SpecialistLocation: Tallahassee, FLJob Type: Full-timeDepartment: Office of Human Subjects Protection | Office of ResearchJob Summary:We are seeking a highly skilled Institutional Review Board Post Approval Compliance Specialist to join our team. The successful candidate will be responsible for...

Job Title:Institutional Review Board Post Approval Compliance SpecialistLocation:Tallahassee, FLJob Type:Full-timeJob Description:Job Summary:The Office of Human Subjects Protection | Office of Research is seeking a highly skilled Institutional Review Board Post Approval Compliance Specialist to join our team. As a key member of our compliance team, you will...

Job SummaryAs a Clinical Review Director at HMSA, you will play a critical role in ensuring compliance with medical and benefit policies, nationally recognized clinical review criteria, accreditation guidelines, and governmental regulations. Your expertise will be essential in directing and evaluating clinical review activities to guarantee accuracy,...

De Novo Review Inc: Seeking a Skilled Legal Intake SpecialistAward-winning boutique law firm De Novo Review Inc, based in South Florida, is expanding its team and looking for an experienced Legal Intake Specialist to connect with and capture new clients. The ideal candidate will have a strong background in credit repair, excellent communication skills, and...

De Novo Review Inc: Seeking a Skilled Legal Intake SpecialistAward-winning boutique law firm De Novo Review Inc, based in South Florida, is expanding its team and looking for an experienced Legal Intake Specialist to connect with and capture new clients. The ideal candidate will have a strong background in credit repair, excellent communication skills, and...

Job OpportunityWe are seeking a highly skilled Mammography Clinical Specialist to join our team at a top-rated facility in Miami, Florida.This is a permanent, full-time position with a competitive pay range of $30-$40 per hour. Benefits include medical, dental, vision, 401K, weekly direct deposit, and more.As a Mammography Clinical Specialist, you will be...