- University of New Mexico (Albuquerque, NM)
- …Grade 16 Position Summary The UNM Comprehensive Cancer Center is seeking a Nurse Practitioner, Physician Assistant or Clinical Nurse Specialist with Prescriptive ... gynecology, and head and neck cancers), adult and pediatric hematologists/ medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with… more
- STG International (Rockville, MD)
- STGi is currently seeking a Registered Nurse -Case Review Specialist . The position is remote and open to candidates nationwide. JOB SUMMARY: Provides direct ... with FOH Business Operations team. Serves as a Registered Nurse Case Review Specialist for the case... Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary The Utilization Review Nurse works as is responsible for ensuring the receipt of high ... reviews for retrospective authorization requests as well as claims disputes. The Utilization Review Nurse will use appropriate governmental policies as well as… more
- Trinity Health (Albany, NY)
- …Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. + Review and update medication list to ensure accurate and ... **Employment Type:** Full time **Shift:** Day Shift **Description:** **Registered Nurse - Endocrinology - Albany, NY** If you are...complete list in electronic medical record (EMR) available for provider review … more
- CVS Health (Lincoln, NE)
- …do it all with heart, each and every day. **Position Summary** **This is a remote work from home role anywhere in the US with virtual training.** American Health ... Holding, Inc (AHH) is a medical management company that is a division within Aetna/CVS...**Required Qualifications** + 5+ years' experience as a Registered Nurse with at least 1 year of experience in… more
- Cognizant (Salem, OR)
- …Friday - Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact by performing advanced level work related to clinical ... the medical necessity determinations to the Health Plan/ Medical Director based on the review of...Based on this role's business requirements, this is a remote position open to qualified applicants in United States.… more
- Trinity Health (Albany, NY)
- …Brings patient to exam room, takes appropriate vital signs and documents in electronic medical record. Review and update medication list to ensure accurate and ... MS & Headache - Albany, NY - full time -hybrid/ remote after training** If you are looking for a...complete list in electronic medical record (EMR) available for provider review … more
- Actalent (Des Moines, IA)
- …healthcare practices and electronic medical record systems. Ability to review medical records and technical specifications and draw defensible conclusions ... Remote HEDIS Nurse Consultant Description HEDIS...provider, and their office staff, regarding the HEDIS initiative Review and abstract 40-50 medical records per… more
- CVS Health (Phoenix, AZ)
- …healthcare for members. **Position Summary** We are seeking a dedicated Utilization Management (UM) Nurse to join our remote team. In this role, you'll be at ... times may vary based on business needs. Location: 100% Remote (US only) **About Us** American Health Holding, Inc....(AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible,… more
- 315 health (Warner Robins, GA)
- …confidence in navigating their healthcare. We are looking for a qualified Registered Nurse (RN) to serve our patient population in the navigation, prevention and ... management of their health through continuous care programs like Remote Patient Monitoring and Chronic Care Management. Our team works fervently to anticipate the… more
- University of Virginia (Culpeper, VA)
- …history and inputs into medical record system prior to visit for physician review + Completes UPG scribe training to documents in the medical record services ... real-time during patient encounters. + Maintain appropriate inventory of medical supplies and/or vaccines for the practice. + Acts...access, and Urinary Cath + Perform clinical prep to review records and studies, along with schedules and ensure… more
- Datavant (Little Rock, AR)
- …+ 3+ years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... you will play a pivotal role in elevating the impact of our medical record documentation. You will conduct daily evaluations and engage in direct communication… more
- Highmark Health (Harrisburg, PA)
- …to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and ... RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) or WV or DE or...Working knowledge of pertinent regulatory and compliance guidelines and medical policies + Ability to multi task and perform… more
- Actalent (Rancho Cordova, CA)
- Utilization Review Nurse About the Role We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective ... patient care from a fully remote environment. This role is ideal for nurses who...and ancillary services using established clinical criteria + Assess medical necessity and determine appropriate levels of care +… more
- State of Colorado (Golden, CO)
- Medical Operations Coordinator ( Nurse V) - Lookout Mountain Youth Services Center Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5166280) ... Apply Medical Operations Coordinator ( Nurse V) - Lookout...include staffing patterns and assignments, training and quality assurance review in collaboration with the DYS Quality Coordinator for… more
- Centene Corporation (New York, NY)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... license.** **Position Purpose:** Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance… more
- Centene Corporation (New York, NY)
- …license; and a NYS Driver's License or Identification card.** **Position Purpose:** The Utilization Review Nurse I provides first level clinical review for ... necessity using appropriate criteria, referring those requests that fail review to the medical director for second...plus holidays, and a flexible approach to work with remote , hybrid, field or office work schedules. Actual pay… more
- Centene Corporation (Denver, CO)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... benefits including a fresh perspective on workplace flexibility. **Location: Position is remote . Prefer candidate to live in PST time zone.** **Schedule: Looking for… more
- Centene Corporation (Baton Rouge, LA)
- …for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering ... member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies… more
- Dartmouth Health (Lebanon, NH)
- …communication and computer skills desired. Required Licensure/Certifications - Licensed Registered nurse with NH eligibility * Remote :Fully Remote ... process. **UR specific experience preferred Responsibilities * Works with Medical Director and appropriate physician(s) to establish Dartmouth-Hitchcock (D-H)… more
