- Actalent (Tampa, FL)
- Actalent is hiring a Clinical Review Nurse role! Job Description The Clinical Reviewer is a telephonic position responsible for recommending discharge ... care guidelines and collaboration with key facility personnel. + Use clinical expertise to review clinical information and criteria to determine if the… more
- Children's Mercy Kansas City (Kansas City, MO)
- …can improve the lives of children beyond the walls of our hospital. Overview The Clinical Review Nurse Care Manager utilizes clinical expertise, ... from admission through hospital stay to discharge. Adeptly uses evidence based clinical practice guidelines to determine the appropriate level of care and the… more
- Medical Mutual of Ohio (OH)
- …provider community, explaining processes for accessing health plan to perform clinical review , identifying appropriate community resources, or otherwise ... pre-employment substance abuse and nicotine testing._ **Title:** _Clinical Appeal & Claim Review Nurse II_ **Location:** _Ohio_ **Requisition ID:** _2500127_ more
- Actalent (Columbus, OH)
- …management + Prior authorization + Utilization review + Clinical review + Patient care + Licensed registered nurse Additional Skills & Qualifications ... Job Description The Authorization Specialist will perform medical necessity and clinical reviews of authorization requests in accordance with regulatory guidelines… more
- Centene Corporation (New York, NY)
- …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, ... workplace flexibility. **Must have an active, unrestricted New York State clinical license.** **Day shift Eastern Standard hours.** **Position Purpose:** Analyzes… more
- Centene Corporation (Nashville, TN)
- …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, ... perspective on workplace flexibility. **RN Compact/Multi-State License Required** **Registered Nurse Strongly Preferred** **Position Purpose:** Performs concurrent reviews, including… more
- Actalent (Sunrise, FL)
- …team. In this role, you'll collaborate with an interdisciplinary team to review and authorize behavioral health and substance use services, ensuring appropriate care ... in crisis, including triage, discharge planning, and aftercare referrals. + Review treatment plans and collaborate with Medical Directors on medical necessity.… more
- Children's Mercy Kansas City (Kansas City, MO)
- …resolve issues. The High-Risk Nurse Lead is an expert at the roles of Clinical Review Nurse Care Manager and Care Coordination Case Manager and provides ... lives of children beyond the walls of our hospital. Overview The High-Risk Nurse Lead manages high risk administrative processes and data related to medical… more
- UCLA Health (Los Angeles, CA)
- Description The Quality Management Clinical Nurse Specialist is responsible for conducting comprehensive facility site reviews (FSRs) to ensure compliance with ... healthcare standards and regulations. This role involves evaluation clinical practices, identifying areas for improvement, and implementing quality improvement… more
- HCA Healthcare (Reston, VA)
- …next step in your career path, we encourage you to apply for our RN Clinical Resource Nurse opening. We review all applications. Qualified candidates will ... **Description** **Introduction** Do you have the career opportunities as a RN Clinical Resource Nurse you want in your current role? We invest in what matters… more
- HCA Healthcare (Savannah, GA)
- …personal growth, we encourage you to apply for our Clinical Research Nurse opening. We promptly review all applications. Highly qualified candidates will be ... Fulltime, weekdays only Do you have the career opportunities as a ** Clinical Research Nurse ** you want with your current employer? We have an exciting… more
- HCA Healthcare (Jacksonville, FL)
- …growth, we encourage you to apply for our Senior Clinical Research Nurse opening. We promptly review all applications. Highly qualified candidates will be ... care like family! Jump-start your career as a Senior Clinical Research Nurse today with HCA Florida...administrative representatives, and the local IRB, if applicable + Review proposed budgets for adequate coverage and recommends changes… more
- HCA Healthcare (Austin, TX)
- …step in your career path, we encourage you to apply for our Float Pool Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a(an) Float Pool Clinical Nurse Coordinator you want in your current role? We invest in… more
- University of Florida (Gainesville, FL)
- …Principal Investigator (PI), on Institutional Review Board submissions. The Clinical Research Nurse will communicate with sponsors, auditors, monitoring ... Clinical Research Nurse Apply now (https://secure.dc4.pageuppeople.com/apply/674/gateway/default.aspx?c=apply&lJobID=536163&lJobSourceTypeID=796&sLanguage=en-us)… more
- HCA Healthcare (Asheville, NC)
- …personal growth, we encourage you to apply for our Clinical Research Nurse opening. We promptly review all applications. Highly qualified candidates will be ... We care like family! Jump-start your career as a Clinical Research Nurse today with Mission Health....or other data collection tools by careful source document review ; monitors data for missing or implausible data +… more
- R1 RCM (Boise, ID)
- …position. **Here's what you will experience working as a Clinical Appeals Nurse :** + Conduct a detailed review of patient medical records and payer ... encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. As our ** Clinical Appeals Nurse ** , you will help our hospital… more
- HCA Healthcare (Lone Tree, CO)
- …step in your career path, we encourage you to apply for our Telemetry Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... The typical candidate is hired below midpoint of the range. **RN Clinical Nurse Coordinator Telemetry** **Full Time Nights** Do you have the career opportunities… more
- HCA Healthcare (Margate, FL)
- …your career path, we encourage you to apply for our Registered Nurse Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... **Description** **Introduction** Do you have the career opportunities as a Registered Nurse Clinical Nurse Coordinator you want in your current role? We… more
- HCA Healthcare (Myrtle Beach, SC)
- …step in your career path, we encourage you to apply for our RN Medsurg Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... up to 15k!** Do you have the career opportunities as a **RN Medsurg Clinical Nurse Coordinator** you want in your current role? We invest in what matters most… more
- HCA Healthcare (Walterboro, SC)
- …your next step in your career path, we encourage you to apply for our Clinical Nurse Coordinator opening. We review all applications. Qualified candidates ... bonus for qualified applicants** Do you have the career opportunities as a Clinical Nurse Coordinator you want in your current role? We invest in what matters… more
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