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Jul 29 RN Utilization Review Per Diem Siena campus St Rose Dominican - Siena Henderson, NV

criteria. Job Summary: The Utilization Review Nurse is responsible for coordinating ... Medical/clinical knowledge, technical and clinical skills, clinical judgment, interpersona... more

Jul 29 Medical Review RN - Per-Diem Mercy Healthcare Sacramento Sacramento, CA

Health designated criteria for primary review. Incorporates into the utilization review ... Health. Accountabilities: 1. Completes medical necessity utilization reviews and... more

Jul 28 Registered Nurse Medical Data Reviewer Cameron Craig Group Syracuse, NY

POSITION INFORMATION : Registered Nurse Medical Data Reviewer (Multi-specialty practice). ... assurance. POSITION SUMMARY: T he Registered Nurse Medical Data Reviewer will provide... more

Jul 28 Medical Claim Review Medical Director - Virtual UnitedHealth Group Baltimore, MD

Employer & Individual Medical Claim Review Medical Director The Medical Director ... provides physician support to Medical Claim Review (MCR) operations, the organizations... more

Jul 26 Medical Review-Nurse Korak Global Healthcare Services Columbus, OH

provider is now hiring two RN's for its Review Dept. Positions are 9-5 Monday-Friday. ... hospital experience if you have experience with Chart Review. Apply Now:... more

Jul 25 Medical Case Manager (Pre Authorization Nurse Reviewer) (06700-061714) Caloptima Orange, CA

requests for the Medical Director review, assuring the gathering of pertinent ... Identifies medical issues for quality management and notifies Medical Director utilizing C... more

Jul 25 Medical Review Registered Nurse (RN) Healthcare Scouts Haltom City, TX

skill set? As a Medical Review Registered Nurse (RN) you will check hospital data, ... and Oncology * Clear and active Registered Nurse (RN) license for TX * Good Computer... more

Jul 23 Medical Review Nurse–Licensed Vocational Nurse (LVN)/Registered Nurse (RN) Healthcare Scouts New Braunfels, TX

Medical Review Nurse – Licensed Vocational Nurse (LVN)/Registered Nurse (RN) role gives ... The ideal Medical Review Nurse – Licensed Vocational Nurse (LVN)/Registered Nurse (RN) ca... more

Jul 22 Medical Management Compliance Review Nurse Southern California Physicians Managed Care Services San Diego, CA

Excellent opportunity for a Medical Management Compliance Review Nurse to work ... We offer competitive salaries and excellent benefits, including: Medical/Dental/Vision Fle... more

Jul 22 Registered Nurse Medical Data Reviewer Career Development Partners Syracuse, NY

POSITION INFORMATION: Registered Nurse Medical Data Reviewer (Multi-specialty practice). ... assurance. POSITION SUMMARY: The Registered Nurse Medical Data Reviewer will provide... more

Jul 22 Registered Nurse (RN) Medical Bill Review Healthcare Scouts Fort Worth, TX

knowledge and skill set? This Registered Nurse (RN) Medical Bill Review position in ... professional growth. As a Registered Nurse (RN) Medical Bill Review you will be... more

Jul 18 CLINICAL CLAIMS REVIEW NURSE - COAST HEALTHCARE MANAGEMENT Tenet Healthcare Lakewood, CA

five years experience in Utilization Review, Medical Coding or Health Experience ... information. * Certified coder; Certified Medical Audit Specialist (CMAS)... more

Jul 17 Lead Claims Review Analyst (Nurse Reviewer) Ces Des Moines, IA

Experience- Previous Medicare Medical Review experience is preferred. Experience ... reviewing medical claims to determine medical necessity and appropriateness is... more

Jul 15 Appeals/Retrospective/Medical Claims Review RN Amalgamated Life Insurance Salem, NH

guidelines and physician support to provide medical review of appellate and retrospective ... closure with accurate documentation of all review outcomes.Applies medical criteria... more

Jul 14 Clinical Care Reviewer UM - RN AmeriHealth Caritas Philadelphia, PA

Management, the Clinical Care Review Nurse is responsible for completing medical ... cases to KFHP Medical Director for medical necessity review when medical information... more

Jul 12 Clinical Coverage Review Medical Director - Virtual UnitedHealth Group Los Angeles, CA

Clinical Coverage Review Medical Director The Medical Director provides physician support ... medical policy. Communicate with and assist Medical Directors outside CCR regarding... more

Jul 11 LPN / Medical Reviewer Kelly Healthcare Resources Surfside Beach, SC

resources to back up review determination* Review interdepartmental requests and medical ... Medical Review Nurse, Medical Records Review Nurse, Medical Claim Review, Medical Record... more

Jul 10 Medicare Medical Review Nurse NCI Information Systems Omaha, NE

NCI: As the Medicare Medical Review QA Nurse ( Quality Control Specialist IV ), you will ... You will support the Medical Review management staff and the Lead Claims Review Analysts b... more

Jul 08 Utilization Review Nurse RN Novant Health Salisbury, NC

medical necessity reviews. All Utilization Review activities are performed in accordance ... Utilization Review or related experience preferred. * Licensure/certification/registration... more

Jun 20 Medical Review Nurse I Strategichealthsolutions Columbia, MD

Medical Review Nurse I – ID061214NE/MD Omaha, NE or Columbia, MD Job Summary: Performs ... medical record review and evaluation of medical services being audited Analyzes... more

Jun 10 RN Manager Utilization Review (232492-005) Concentra Fort Lauderdale, FL

Nurse • 3+ years’ experience in Utilization and Quality Improvement • HEDIS ... under the direction of the Center Medical Director. Demonstrated excellent... more

May 30 CASE REVIEW COORDINATOR, RN, Per Diem Faulkner Hospital Boston, MA

us make a difference. Requirements Case Review Coordinator- Case Management, per ... in-patient Case Management and Utilization Review. Basic computer knowledge. Experience... more

May 20 Supervisor, UM Review (RN) AmeriHealth Caritas Philadelphia, PA

05/20/2014 - Pennsylvania - Philadelphia - Medical Management - Mid Level - ... Unit staffs, who are performing concurrent review, discharge planning, case management... more

May 07 Anesthesia Quality Review Registered Nurse RN Coordinator Lahey Health Burlington, MA

review as well as retrospective chart review. 3) Interacts with caregivers to ... Acts as member or facilitator on hospital or medical committees, preparing agendas,... more

Feb 23 Utilizat Review LPN Novant Health Charlotte, NC

care, level of care, and quality of care medical reviews for hospitalized patients. ... initial, concurrent, and retrospective medical record reviews. Makes utilization... more

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