Medical Clinical Review – RN/LPN

5 days ago


Baltimore, Maryland, United States Charter Global Full time $80,000 - $120,000 per year

Job Title: Medical Clinical Review – RN/LPN

Location: Baltimore, MD (Hybrid)

Duration:12+ Months Contract

PURPOSE:

The Clinical Medical Review Nurse handles day to day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication. The incumbent will handle pre and post claim medical review for Commercial, FEP and Medicare Advantage Plans. This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies. This role will also understand the merits of legal or accreditation actions.


  • Clinical Review

    3 days ago


    Baltimore, Maryland, United States nTech Workforce Full time $80,000 - $120,000 per year

    Title: Clinical Review - Registered NurseLocation: Baltimore, MD Hybrid)Duration: 12 Months Contract + ExtensionJob Description:Terms of EmploymentContract, 12 Months (Possible Extension / Permanent Conversion)This position requires residence in Maryland and the ability to work on-site at our client's Baltimore, MD (Canton neighborhood) office 2-3 days per...


  • Baltimore, Maryland, United States Zolon Tech Inc. Full time $60,000 - $120,000 per year

    Job Description:The Clinical Medical Review Specialist (a licensed clinical professional) will play a key role in supporting the HEDIS Quality Team. This position involves medical record retrieval, chart abstraction, and data validation using proprietary tools in alignment with NCQA specifications. The specialist will handle a range of responsibilities...


  • Baltimore, Maryland, United States WATSON CLINIC LLP Full time

    THE IDEAL CANDIDATE NEED TO BE AN LPN OR A MEDICAL ASSISTANTEssential Functions· Identifies and evaluates patient needs by way of telephone triage.· Administers medication including injections; documents medication given or prescribed by ordering physician as required.· Identifies patient and family education needs and provides instruction.· Recognizes...


  • Baltimore, Maryland, United States AdeIphi MedicaI Staffing Full time $65,000 - $120,000 per year

    Summary:Ref #: CP-LPN-MD-Balt.Profession: Licensed Practical Nurse.Job Type: Contract/Per Diem.Location: Baltimore, MD.Start: ASAP.Facility Type: SNF/ALF.Shift Type: Days, Evenings, Nights.Rate: $32.6/hour. Requirements:Valid and active Licensed Practical Nurse State license.BLS certification. Responsibilities:Deliver direct nursing care to patients, under...


  • Baltimore, Maryland, United States FutureCare Full time $31 - $36

    OverviewAt FutureCare our Licensed Practical Nurses are our frontline heroes and are the heart of healthcare. Through their unwavering commitment and hands on approach to deliver the highest standards of quality, our talented compassionate LPN's wear a badge of courage as they provide support and care for our residents. Making a difference, providing hope,...


  • Baltimore, Maryland, United States FutureCare Full time $41,250 - $75,960 per year

    OverviewAt FutureCare our Licensed Practical Nurses are our frontline heroes and are the heart of healthcare. Through their unwavering commitment and hands on approach to deliver the highest standards of quality, our talented compassionate LPN's wear a badge of courage as they provide support and care for our residents. Making a difference, providing hope,...


  • Baltimore, Maryland, United States Scene Health Full time $65,000 - $70,000 per year

    Job Title: Clinical Adherence CoachLocation: Remote (U.S.)Scene's 360° model of care enhances the gold standard of medication adherence, Directly Observed Therapy. Combining personalized video coaching, education, and motivational content, we bring healthcare professionals, patients, and their families together to solve the $500B medication nonadherence...


  • Baltimore, Maryland, United States Pine Heights Comprehensive Treatment Center Full time $27 - $28

    OverviewOutpatient MAT Opioid Treatment Program (OTP)Seeking: LPN Dispensing NurseFull Time Hours: Monday - Friday: 5:00 AM to 1:30 PMOur Benefits: Semi-Annual Bonus Program Medical, Dental, and Vision insurance Competitive 401(k) plan Paid vacation and sick time Early morning hours offering a great work/life balance Opportunity for growth that is second...


  • Baltimore, Maryland, United States FutureCare Full time $48,000 - $64,000 per year

    OverviewAt FutureCare our Licensed Practical Nurses are our frontline heroes and are the heart of healthcare. Through their unwavering commitment and hands on approach to deliver the highest standards of quality, our talented compassionate LPN's wear a badge of courage as they provide support and care for our residents. Making a difference, providing hope,...


  • Baltimore, Maryland, United States Mercy Medical Center, Baltimore, MD Full time $60,000 - $90,000 per year

    SummaryJoin Our Team at Mercy Medical Center – Now Hiring a Clinical Quality CoordinatorMercy Medical Center is honored to be recognized by Newsweek as one of America's Most Trustworthy Companies for three consecutive years (2023–2025) and as one of America's Greatest Workplaces for Women in 2025. Additionally, we are proud to be a multi-time recipient...