- 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, ... Hours with occasional weekends and holidays.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and… more
- Actalent (Miami, FL)
- Immediate hiring for "Remote Clinical Review RN " Job Description: + Review approximately 20 cases a day for medical necessity. + Advocate for and protect ... : + 3+ Years of experience working with utilization management, concurrent review , prior authorization, utilization review , case management, and… more
- Premier Health (Dayton, OH)
- …experience Prior job title or occupational experience: Case management, utilization review , clinical nurse Prior specific functional ... FOR STATUS INTEGRITY FULL-TIME / DAY SHIFT The CSI Clinical Analyst is a registered professional nurse ...CSI Clinical Analyst is a registered professional nurse with knowledge and expertise in process analysis, … more
- Molina Healthcare (Idaho Falls, ID)
- …**Preferred Experience** Previous experience in Hospital Acute Care, ER or ICU, Prior Auth, Utilization Review / Utilization Management and knowledge of ... compliance with all state and federal regulations and guidelines. + Analyzes clinical service requests from members or providers against evidence based clinical… more
- University of Miami (Miami, FL)
- …Staff. 25. Performs second chemotherapy order check prior to administration by another clinical trials nurse . Clinical Research Nurse 2 Clinical ... SCCC has an exciting opportunity for a Full Time Clinical Research Nurse 2 to work at...prior to beginning research related activities. 3. Provides clinical trial support in the hospital and/or clinic setting… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 06/18/2025 **Requisition Number** PRN42207B **Job Title** PS Clinical Nurse Specialist **Working Title** Clinical Research Nurse ... people and communities. This may include description of your prior experiences related to research, prevention, clinical ...of patients based on specialty area. Problem Solving The Clinical Nurse Specialist makes decisions independently and… more
- Texas A&M University System (College Station, TX)
- …of insurance guidelines and prior authorization processes. + Ability to review and interpret clinical documentation to determine what is required for ... Job Title Registered Nurse II - Prior Authorization &...are denied. + Collaborate with providers to gather necessary clinical documentation and address denials or escalations. + Tracks… more
- University of Utah (Salt Lake City, UT)
- Details **Open Date** 06/24/2025 **Requisition Number** PRN42286B **Job Title** PS Clinical Nurse **Working Title** PS Clinical Nurse **Job Grade** UGR ... Posting **Pay Rate Range** $30-$41 **Close Date** 08/31/2025 **Priority Review Date (Note - Posting may close at any...Clinical Research Unit (**CRU**) is seeking an experienced clinical nurse to join our team! We… more
- Veterans Affairs, Veterans Health Administration (Middleton, WI)
- …in patient care through systematic evaluation and analytical review of clinical information. Responsibilities Responsibilities of the RUR nurse include, but ... Summary The Revenue Utilization Review (RUR) nurse is under the...Patient Accounting Centers (CPAC) for revenue reimbursement. The RUR nurse applies advanced clinical knowledge, communication skills,… more
- Johns Hopkins University (Baltimore, MD)
- …part of a team of nurses, physicians, and medical office staff. The Clinical Nurse will demonstrate responsibility and accountability with patients, family ... patient care. + A minimum of two years of specialized experience in Clinical Gastroenterology. Classified Title: Clinical Nurse Role/Level/Range: ACRP/03/ME… more
- Veterans Affairs, Veterans Health Administration (Reno, NV)
- …or testing, as a condition of employment. Preferred Experience: Certificate for Clinical Nurse Leader (CNL) or receiving education to obtain certificate ... the VHA Education Loan Repayment Services program office after review of the EDRP application. Responsibilities Major Duties Include...Nursing may have opportunity to become registered as a nurse with a state licensing board prior … more
- HCA Healthcare (Live Oak, TX)
- …important to you, we encourage you to apply for our ICU Clinical Nurse Coordinator opening. Our team will promptly review your application. Highly qualified ... in their positions. Join our Team as an ICU Clinical Nurse Coordinator and access programs to...encompassed by job duties; and must check with supervisors ( prior to job performance) if there is a question… more
- WelbeHealth (Pasadena, CA)
- …communities by providing comprehensive medical care and community-based services. The WelbeHealth Clinical Nurse Manager is accountable for the delivery of ... the Clinical Services Director (CSD), the WelbeHealth Clinical Nurse Manager organizes and directs the...Quality Improvement Director, serve as the audit lead for clinical and nursing elements during CMS/DHCS audit review… more
- Penn State Health (Hershey, PA)
- …Hahn at ###@pennstatehealth.psu.edu (//###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** The Registered Nurse Clinical Staff Leader will ensure clinical ... a role model for professional nursing practice. The RN Clinical Staff Leader will review appropriate staffing...for assistance._ **Union:** Non Bargained IND567 **Position** RN Registered Nurse Clinical Staff Leader - VARIED SHIFTS… more
- Intermountain Health (Billings, MT)
- **Job Description:** **Job Description** The Nurse Clinical Leader provides leadership and clinical expertise during their shift and within their department. ... constructive discipline, and completion of annual employee performance reviews. The Clinical Nurse Leader provides leadership support for professional… more
- Geisinger (Wilkes-Barre, PA)
- Job Summary The Clinical Documentation Improvement Program (CDI) is designed to improve the physician's documentation in the patient's medical record, supporting the ... of care of the patient. The role of the Clinical Documentation Improvement Specialist (CDIS) is to assist the...highly trained staff members to perform a concurrent inpatient review of the record. This allows the record to… more
- Penn State Health (Hershey, PA)
- …Ceballos at ###@pennstatehealth.psu.edu (MAILTO://###@pennstatehealth.psu.edu) **SUMMARY OF POSITION:** The Registered Nurse Clinical Staff Leader will ensure ... a role model for professional nursing practice. The RN Clinical Staff Leader will review appropriate staffing...information._ **Union:** Non Bargained IND567 \#LI-TB1 **Position** RN Registered Nurse Clinical Staff Leader - VARIED SHIFT… more
- Hackensack Meridian Health (Paramus, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Clinical Research Nurse ** is responsible for coordinating and overseeing clinical ... Patient Care in clinical research trials. The Clinical Research Nurse carries out the research...after March 31, 2024. Team members hired or transferred prior to March 31, 2024 require a minimum of… more
- Hackensack Meridian Health (Hackensack, NJ)
- …to transform healthcare and serve as a leader of positive change. The ** Clinical Research Nurse ** is responsible for coordinating and overseeing clinical ... Patient Care in clinical research trials. The Clinical Research Nurse carries out the research...after March 31, 2024. Team members hired or transferred prior to March 31, 2024 require a minimum of… more
- Cleveland Clinic (Cleveland, OH)
- …and the Governing Body of the applicable hospitals. **CNS** + Currently licensed as a Clinical Nurse Specialist in applicable state(s). + Must be licensed as an ... responsibilities. This position requires at least one year of prior PA or NP experience, and OR First Assist...RN in applicable state(s). + National certification as a Clinical Nurse Specialist by nationally accredited organization… more