CVS Health CorpPrior Authorization Clinical Reviewer CVS Health CorpPrior Authorization Clinical ReviewerNC$26.01–$74.78 / yearApplication of critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and medical necessity criteria for appropriate utilization of services for members with disabilities and special healthcare needs. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
MMSNewCardiology Medical Reviewer (Project-Based) - Remote MMSCardiology Medical Reviewer (Project-Based) - RemoteRaleigh, NCRemotePart timeWith a global footprint across four continents, MMS not only maintains an industry-leading customer satisfaction rating but also fosters a collaborative and inclusive work environment where employees can thrive. Responsible for strategies in pre and post marketing risk management, as well as keeping abreast of pharmacovigilance methods and trends in published literature and global regulations.
MMSCardiology Medical Reviewer (Project-Based) MMSCardiology Medical Reviewer (Project-Based)Raleigh, North CarolinaWith a global footprint across four continents, MMS not only maintains an industry-leading customer satisfaction rating but also fosters a collaborative and inclusive work environment where employees can thrive. Responsible for strategies in pre and post marketing risk management, as well as keeping abreast of pharmacovigilance methods and trends in published literature and global regulations.
Advocate Health and Hospitals CorporationNewBilling Reviewer I CTSI Advocate Health and Hospitals CorporationBilling Reviewer I CTSIWake Forest, North CarolinaVerifies and resolves discrepancies by utilizing the tools and resources available, e.g., EPIC billing system, OnCore (clinical trial management system), medical record documentation, Charge Master data, Patient Accounting/VMG Business Offices and/or contacting study personnel in the appropriate internal department. Performs review of all technical and professional charges generated from EPIC and any ancillary subsystems for allocation to the research study account, insurance claim and/or patient statement to verify the accuracy of charges as they compare to the research billing intention/plan outlined in the protocol Billing Grid.
Zelis Healthcare, Inc.Inpatient DRG Reviewer-3 Zelis Healthcare, Inc.Inpatient DRG Reviewer-3NCWhere the regrouped 'new DRG' differs from what was originally claimed by the provider, write a customer facing 'rationale' or 'findings' statement, highlighting the problems found and justifying the revised choices of new codes and DRG, based on the clinical evidence obtained during the review. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.
Duke UniversityCLINICAL RESEARCH NURSE COORDINATOR Duke UniversityCLINICAL RESEARCH NURSE COORDINATORDurham, NC$64,966–$104,996 / yearParticipates in or leads day-to-day operations of clinical research studies conducted by principal investigator(s) at Duke Medicine; performs a variety of duties involved in the collection, compilation, documentation, and analysis of clinical research data. Composed of more than 2,500 faculty physicians and researchers, more than 1,300 students, and more than 6,000 staff, the Duke University School of Medicine along with the Duke University School of Nursing, Duke University Health System, and the Private Diagnostic Clinic (PDC) comprise Duke Health.
Duke UniversityClinical Research Nurse Coordinator Duke UniversityClinical Research Nurse CoordinatorDurham, NC$64,966–$104,996 / yearType of Research: The Clinical Research Professional (CRP) in the Cardiothoracic Research Division within Surgery is a specialized research team member responsible for coordinating and executing complex clinical trials involving investigational medical devices, including greater-than-minimal risk studies conducted under an Investigational Device Exemption (IDE). Working under the direction of the Principal Investigator, the CRP ensures studies are conducted safely, ethically, and in compliance with Good Clinical Practice (GCP), FDA regulations, and institutional policies, while managing patient screening and enrollment, facilitating informed consent, overseeing regulatory submissions, and maintaining accurate data and device accountability.
Duke UniversityCLINICAL RESEARCH COORDINATOR Duke UniversityCLINICAL RESEARCH COORDINATORDurham, NC$59,829–$99,960 / yearOccupational Summary Participates in or leads day-to-day operations of clinical research studies conducted by Principal Investigator(s) (PI) at Duke Health; performs a variety of duties involved in the collection, compilation, documentation, and analysis of clinical research data. Composed of more than 2,500 faculty physicians and researchers, more than 1,300 students, and more than 6,000 staff, the Duke University School of Medicine along with the Duke University School of Nursing, Duke University Health System, and the Private Diagnostic Clinic (PDC) comprise Duke Health.
Duke UniversityClinical Research Coordinator Duke UniversityClinical Research CoordinatorDurham, NC$59,829–$99,960 / yearThis CRP will perform EMR review, participant screening, travelling for screening events as needed, consenting, enrollment, recruitment and retention, conducting study visits in the healthcare setting as well as in the community, management of specimens, study and site documentation, data collection and entry, query resolution, interventional- drug/device studies, IP management, IRB/regulatory submissions and maintenance, and participant payment processing. Composed of more than 2,500 faculty physicians and researchers, more than 1,300 students, and more than 6,000 staff, the Duke University School of Medicine along with the Duke University School of Nursing, Duke University Health System and the Private Diagnostic Clinic (PDC) comprise Duke Health.
EvolentNewInterventional Pain Management Field Medical Director EvolentInterventional Pain Management Field Medical DirectorRaleigh, NC$100–$110 / hourServe as the Physician Clinical Reviewer for Interventional Pain Management, reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert. Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid, and is not identified as an “excluded person” by the Office of Inspector General of the Department of Health and Human Services or the General Service Administration (GSA), or reprimanded or sanctioned by Medicare.
Bioventus IncMarketing Product Manager - Surgical Ultrasonics Bioventus IncMarketing Product Manager - Surgical UltrasonicsDurham, NCThis position collaborates with cross functional teams such as Product Development, Sales, Legal, Regulatory, Medical Education, Sales Training, Reimbursement, Medical Affairs, and Finance to ensure the product/brand/product line remains relevant to US customers and that all initiatives support the product/brand promise. Creates innovative marketing solutions, programs and tools (presentations, educational materials, selling materials, tradeshow content, digital assets and campaigns, etc.) to create value and support the needs of the sales team, aligning these to organizational priorities, budget, and needs assessment.
Syneos Health IncSenior Medical Writer - Regulatory Documents - CSR /Protocol - Late Phase Syneos Health IncSenior Medical Writer - Regulatory Documents - CSR /Protocol - Late PhaseMorrisville, NCAll Jobs - 6 minutes Recommended Jobs Field Reimbursement Manager Field Reimbursement Manager Field Reimbursement Manager Specialty Sales Representative Experienced Project Manager - Full-Service Share this job Apply Inside Syneos Health Our Values Who We Are Our Solutions Diversity, Equity, and Inclusion Why Work Here Discover what our more than 29,000 employees already know. Interacts and builds good working relations with clients, department head, and peers in data management, biostatistics, regulatory affairs, and medical affairs as necessary to produce writing deliverables.