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CAREERBUILDER APPLY

Full-Time

Located in Honolulu, Hawaii, this position is responsible for coordinating and conducting various review activities as defined by HSAG’s contract with the State of Hawaii, Department of Human Services MedQUEST Division (DHS/MQD). Clinical review activitie...

Health Services Advisory Group, Inc.

Honolulu, HI

CAREERBUILDER APPLY

Full-Time

Job Number: 442502 Appeal Nurse Reviewer Description: Advanced Resources is recruiting for one of our top clients in Chicago! We are looking for an Appeal Nurse Reviewer for a managed care organization in the loop. The Appeal Nurse Reviewer is an integral...

Chicago, IL

Full-Time | Pay: $40.00 - $45.00/hour

MUST HAVES 1) RN with active RI license 2) 5+ years acute care clinical experience 3) Strong data entry and case review experience, understanding of compliance and able to review appeals coming in from providers and members JOB DESCRIPTION: * Investigate...

Providence, RI

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CAREERBUILDER APPLY

Full-Time

Utilizes medical knowledge, established clinical guidelines, and physician support to provide medical review of care rendered to patients by providers and determine if care provided is medically necessary and appropriate. Applies medical criteria guidelin...

ALICARE MEDICAL

Salem, NH

Full-Time

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide. HealthCore, a health outcomes research company in Wilmington, DE, is seeking a Nurse Reviewer to join our dynamic, rapid...

Andover, MA

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Full-Time

MenorahMedical Center – Overland Park, KS Registered Nurse – Clinical Reviewer Menorah Medical Center, afull-service, acute care hospital located on the corner of 119th and Nall inOverland Park, serves the community's healthcare needs by providingcompassi...

Menorah Medical Center

Overland Park, KS

CAREERBUILDER APPLY

Full-Time

The National Nurse Review position provides support to the carrier's personnel regarding medical care, medical necessity, relatedness and causality. Major Duties and Responsibilities: Review bills including HFCA's and UB92's on injured parties, involved i...

Iselin, NJ

Full-Time

* Competitive pay and sign on bonus * Performs utilization management activities to ensure the provision of safe, timely, appropriate, and necessary covered healthcare services to members; promotes effective resource management by directing member care to...

Cleveland, OH

Full-Time | Pay: $0.00 - $27.00/hour

Are you an experienced RN looking for a position without direct patient care? We are actively recruiting a top-notch Spanish speaking Registered Nurse for a fantastic temp to hire opportunity to work within an international firm on the eastside of Rochest...

Med-Scribe, Inc.

Pittsford, NY

CAREERBUILDER APPLY

Full-Time

This is not a remote position; our office is located in Carrollton, TX. Job Summary: The Nurse Reviewer is responsible for conducting concurrent and retrospective chart review for clinical, financial and resource utilization information. To capture the cl...

Cantex Continuing Care Network

Carrollton, TX

Full-Time

Working At Aetna -- the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes workin...

Fort Lauderdale, FL

CAREERBUILDER APPLY

Full-Time

Title : RN or LPN Clinical Care Reviewer Duration : 3+ months Location : Des Moines, IA Top Skills : Review Provider Requests, Inpatient/Outpatient Services, Registered Nurse (RN) or LPN Job Description: Clinical Care Reviewer UM The primary purpose of th...

Des Moines, IA

CAREERBUILDER APPLY

Full-Time

LPN/Medical Reviewer Kelly Healthcare Resources (KHR) has an opportunity for an LPN/Medical Reviewer to come and join our client located in Columbia, SC ! As the LPN/Medical Reviewer with a large health insurance provider, you will be responsible for revi...

Columbia, SC

CAREERBUILDER APPLY

Full-Time

HealthCare Scouts Inc. is currently interviewing for a healthcare organization seeking a community-oriented Clinical Care Reviewer. This organization is the nation’s leader in health care solutions and a workplace favorite in our nursing community. As a C...

Confidential

Des Moines, IA

CAREERBUILDER APPLY

Full-Time

Currently seeking a RN Clinical Care Reviewer for one of our premier clients in Philadelphia, PA Contract: 3-6+ months This job will have the following responsibilities: Responsible for completing medical necessity reviews Work closely with members and pr...

Philadelphia, PA

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Full-Time

Texas Oncology is searching for a Insurance Clinical Reviewer. The Insurance Clinical Reviewer processes and audits the medical necessity for each patient chemotherapy treatment and documentation of regimen relative to pathway adherence, obtains insurance...

Austin, TX

Part-Time

KEPRO is a rapidly growing national qualityimprovement and care management organization. We work to ensure that over 1billion people receive the right care, at the right time, in the right setting. RN Reviewer Supports the Family Medical Leave administr...

Columbia, MD

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Full-Time

Summary of Objectives: Mobile Health is a growing occupational healthcare organization that utilizes technology solutions and customer service to fuel its growth. Mobile Health owns and operates six facilities in New York City and is a leading provider of...

New York, NY

CAREERBUILDER APPLY

Full-Time

Full-time Resident Reviewer position available. Clinician will complete bio-psychosocial assessments with individuals diagnosed with a Severe Mental Illness at various long term care facilities. Clinician will determine recommendations for transition and...

Chicago, IL

CAREERBUILDER APPLY

Full-Time

Case Manager / RN Kelly Services has an exciting opportunity for a RN / Case Manager to come work with our client located in Columbia, SC. If you’re ready to help individuals maintain a healthy life, then apply today! Overall Purpose of the job: Reviews a...

Columbia, SC

Full-Time

Med-Scribe, Inc. recruits top nursing talent. We are seeking an experienced Registered Nurse for a non-clinical role within an international firm on the eastside of Rochester. For 40 years, our client has partnered with federal, state and local government...

Pittsford, NY

CAREERBUILDER APPLY

Full-Time

Are you experienced in home health case management? Do you enjoy direct contact with clients in their homes? Have you conducted Home Health assessments, worked in a Long-Term Care facility or Hospice? If so, we have the perfect long-term full-time tempora...

Washington, DC

Full-Time

Collects and submits reliable data to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) through high-quality data compilation, documentation, and entry into the ACS NSQIP database of all eligible surgeries for the...

Memorial Healthcare System

Hollywood, FL

CAREERBUILDER APPLY

Full-Time

Oversee and develop quality activities under the management of the Director of Quality and Patient Safety Review OASIS assessments to ensure accuracy, and compliance with state and federal regulations Utilize regulatory criteria to implement and examine c...

Cambridge, MA

Full-Time

Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or clinical guidelines. Provides support and revi...

Nashville, TN

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