- CHRISTUS Health (Wake Village, TX)
- Description Summary: The Registered Nurse Clinical Care Coordinator is responsible for evaluating, coordinating, processing, screening, and documentation of ... patient entry into the CHRISTUS Health System. The Registered Nurse Clinical Care Coordinator...CMO when discrepancies are present. * Performs the initial clinical medical necessity review utilizing evidence-based criteria… more
- Elevance Health (Miami, FL)
- ** Clinical Review Nurse I -...which would provide an equivalent background. + Current unrestricted RN license required. + **This position is part of our ... Friday 8 am - 5 pm EST or CST. Hours are flexible.** The ** Clinical Review Nurse I** is responsible for reviewing and making medical determinations as… more
- Hackensack Meridian Health (Little Falls, NJ)
- …+ Home Care Experience Licenses and Certifications Required: + NJ State Professional Registered Nurse License. + Certificate for Oasis Specialist (COS-C, COQS, ... appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review ...issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for… more
- Hackensack Meridian Health (Brick, NJ)
- …+ Home Care Experience Licenses and Certifications Required: + NJ State Professional Registered Nurse License. + Certificate for Oasis Specialist (COS-C, COQS, ... appropriate documentation for coding, OASIS and Hospice, and other clinical assessment tools as needed. + Review ...issues to the Director of the certified operation, Hospice Clinical Director, and the Nurse Manager for… more
- Centene Corporation (New York, NY)
- …**License/Certification:** + LPN - Licensed Practical Nurse - State Licensure required + RN - Registered Nurse license preferred. Pay Range: $25.97 - ... the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified,… more
- Centene Corporation (Sacramento, CA)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, ... on workplace flexibility. **Fully Remote position that requires a CA RN Licensure.** **Position Purpose** : Performs concurrent reviews, including determining… more
- Actalent (Atlanta, GA)
- …to providers to request additional details if applicable. Qualifications: + Active RN License + Prior Utilization management/Concurrent review experience + ... Actalent is currently hiring for Remote Utilization Review RNs! Job Description: + Reviewing authorization requests + Utilizing evidence-based criteria and making a… more
- System One (Baltimore, MD)
- ALTA IT Services is staffing a contract opportunity for a Clinical HEDIS Specialist support a leading health insurance customer. The main duties include conducting ... go onsite in Baltimore, MD Must have LPN or RN Responsibilities: + Accurately and efficiently over-read medical record...found. Correct errors identified through over-read process, including a re- review of charts that may contain similar errors. +… more
- CommonSpirit Health Mountain Region (Durango, CO)
- …flourish and leaders who care about your success. Assist with training and coordinating clinical review and quality assurance. Lead and review the ... clinical care and documentation practices related to patients/residents. Review and evaluate quality data to determine areas needing...documentation of the home health and/or hospice patient. + Registered Nurse + Valid CO Driver's License.… more
- HCA Healthcare (Mcallen, TX)
- …for benefits may vary by location._ **Job Summary and Qualifications** The Review Nurse Clinical Reviewer position encompasses multiple responsibilities ... efficiently. Are you passionate about delivering patient-centered care? Submit your application for Registered Nurse Quality position and spend more time at the… more
