Medical Clinical Review – RN/LPN
5 days ago
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.
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Clinical Review
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Baltimore, Maryland, United States nTech Workforce Full time $80,000 - $120,000 per yearTitle: 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...
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HEDIS Clinical Reviewer
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Baltimore, Maryland, United States Zolon Tech Inc. Full time $60,000 - $120,000 per yearJob 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...
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Baltimore, Maryland, United States WATSON CLINIC LLP Full timeTHE 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...
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LPN/LVN - Long Term Care #CP-LPN-MD-Balt
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Baltimore, Maryland, United States AdeIphi MedicaI Staffing Full time $65,000 - $120,000 per yearSummary: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...
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Licensed Practical Nurse LPN
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Clinical Adherence Coach
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LPN Dispensing Nurse
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Licensed Practical Nurse LPN
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Clinical Quality Coordinator
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Baltimore, Maryland, United States Mercy Medical Center, Baltimore, MD Full time $60,000 - $90,000 per yearSummaryJoin 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...