• Bariatric Clinical Reviewer

    HCA Healthcare (Salt Lake City, UT)
    …Do you want to join an organization that invests in you as a(an) Bariatric Clinical Reviewer ? At St. Mark's Hospital, you come first. HCA Healthcare has ... a difference. We are looking for a dedicated Bariatric Clinical Reviewer like you to be a...Committee meetings annually with one being the annual comprehensive review meeting. Timely data entry is required per the… more
    HCA Healthcare (05/04/25)
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  • Clinical Reviewer III (ECSS), Remote…

    Magellan Health Services (Baton Rouge, LA)
    …family engagement, and system-level collaboration with other child-serving agencies. The Clinical Reviewer will support the implementation and ongoing oversight ... staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results and/or corrective… more
    Magellan Health Services (05/15/25)
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  • Registered Nurse Clinical Reviewer

    HCA Healthcare (Houston, TX)
    …apart from any other healthcare provider. We are seeking a(an) Registered Nurse Clinical Reviewer to join our healthcare family. **Benefits** The Woman's ... empowers their passion for patient care. Apply today for our Registered Nurse Clinical Reviewer opportunity. **Job Summary and Qualifications** We are seeking a… more
    HCA Healthcare (03/16/25)
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  • Clinical Documentation Specialist 2…

    University of Miami (Hialeah, FL)
    …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Concurrent Quality Reviewer of our hospital reviews documentation in the electronic...the computer assisted coding software, recognizing inappropriate application of clinical coding regulations/guidelines, and revising the codes assigned based… more
    University of Miami (05/07/25)
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  • RN Clinical Reviewer

    HCA Healthcare (Kingwood, TX)
    **Description** **Introduction** Do you have the career opportunities as a(an) RN Clinical Reviewer you want in your current role? We invest in what matters most ... **Job Summary and Qualifications** We are seeking a RN Clinical Reviewer for our facility to ensure...for our Registered Nurse RN Emergency Department opening. We review all applications. Qualified candidates will be contacted by… more
    HCA Healthcare (05/15/25)
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  • UM Clinical Reviewer

    Centers Plan for Healthy Living (Margate, FL)
    …applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works within a multidisciplinary team to help ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine medical… more
    Centers Plan for Healthy Living (04/15/25)
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  • Clinical Documentation Specialist, Second…

    SSM Health (MO)
    …Type:** Regular **Job Highlights:** Must have prior and direct Clinical Documentation experience **Preferred Qualifications:** + CCDS certification + Proficiency ... **Required Qualifications:** + Prior experience as a Second Level Reviewer + Two years in an acute care setting...in an acute care setting with two years experiencein clinical documentation or 4 years experience in clinical more
    SSM Health (03/19/25)
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  • Bariatric RN Clinical Reviewer

    Catholic Health Initiatives (Lexington, KY)
    **Responsibilities** **JOB SUMMARY:** The Bariatric Clinical Reviewer plays a crucial role in ensuring departmental compliance with MBSAQIP Data Registry and ... 12 months of hire Experience: Three (3) to five (5) years of clinical experience. Skills: Current Basic Life Support for Healthcare Provider certification. The RN… more
    Catholic Health Initiatives (04/26/25)
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  • Clinician Reviewer RN OP Temp

    US Tech Solutions (Canton, MA)
    …possible extension)** Notes: Fully remote, MA license required.** **Job Summary The Clinical Reviewer is a licensed professional -a Registered Nurse preferred- ... a clinically complex caseload of varied requests for services. The Clinical Reviewer is responsible for making the determination of medical necessity and,… more
    US Tech Solutions (03/06/25)
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  • RN MDS Reviewer

    Commonwealth Care Alliance (Boston, MA)
    …monitoring. The RN MDS Reviewer is a member of the Minimum Data Set (MDS) Clinical Review team of the Care Planning Unit. The RN MDS Reviewer supports ... clinical findings. Where gaps occur, the RN MDS Reviewer provides feedback to Care Planners to facilitate optimal...form based on diagnoses / information gathered from record review . + Prepares printed MDS forms for data entry.… more
    Commonwealth Care Alliance (05/21/25)
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  • Technical Reviewer - Quality Control/CMC…

    LGC Group (Petaluma, CA)
    …bioinformatics, biology, chemistry, manufacturing and analytical services that support discovery, pre- clinical and clinical trials and scale-up manufacture. With ... to cGMP of multigram to kilograms of API for pre- clinical and clinical development. Our site in...and analytical expertise in Kulmbach. Job Description The Technical Reviewer in LGC AxoLabs Quality Control is a dual… more
    LGC Group (04/27/25)
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  • RN - Clinical Documentation Specialist,…

    SSM Health (MO)
    …Type:** Regular **Job Highlights:** Must have prior and direct Clinical Documentation experience **Preferred Qualifications:** + CCDS certification + Proficiency ... mortality reviews. **Required Qualifications:** + 12 months of experience as a Clinical Documentation Specialist + Graduate of accredited school of nursing, PA, NP,… more
    SSM Health (05/21/25)
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  • Dispute Resolution Reviewer I

    St. George Tanaq Corporation (Lansing, MI)
    …and Skills** + One (1) year of Medicare appeals, medical review , clinical , healthcare regulatory interpretation/application, healthcare compliance or related ... Dispute Resolution Reviewer I Fully Remote*GA Job Type Full-time Description...or related discipline Additional experience in Medicare appeals, medical review , clinical , or other related experience in… more
    St. George Tanaq Corporation (05/07/25)
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  • Clinical Professional RN Clinical

    SUNY Upstate Medical University (Syracuse, NY)
    Job Summary: High-level clinical review of patients admitted to the University Hospital for the purpose of risk identification and referral to clinical ... agencies and conduct internal quality reviews through the institution-defined quality review process. Supports the Attorney General's office in the review more
    SUNY Upstate Medical University (04/04/25)
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  • Second Level Reviewer I

    AdventHealth (Maitland, FL)
    …year **The role you'll contribute:** _Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the ... Clinical Documentation Integrity Manager, and in collaboration with physicians,...with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality… more
    AdventHealth (05/03/25)
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  • Genetic Counselor Reviewer

    Elevance Health (Los Angeles, CA)
    …or requires physician review or override. + Clearly and concisely documenting clinical review and other case interactions in online database in adherence to ... **JR150009 Genetic Counselor Reviewer ** The genetic counselor reviewer (GCR)...for authorization requests and determining their appropriateness per designated clinical guidelines, clinical policies, and client rules.… more
    Elevance Health (04/29/25)
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  • Nurse Reviewer I

    Elevance Health (Grand Prairie, TX)
    **Nurse Reviewer I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and ensures essential face-to-face onboarding and skill development. The **Nurse Reviewer I** will be responsible for conducting preauthorization, out of network… more
    Elevance Health (05/22/25)
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  • Nurse Reviewer I (Nclex)

    Elevance Health (San Juan, PR)
    …information technology and business operations services for health plans._ **Nurse Reviewer I** **Location:** This role requires associates to be in-office 1 ... Friday but must be flexible according to business needs. The **Nurse Reviewer I** is responsible for conducting preauthorization, out of network and appropriateness… more
    Elevance Health (05/13/25)
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  • Psychologist Reviewer

    Centene Corporation (Frankfort, KY)
    …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, ... a fresh perspective on workplace flexibility. **Centene is Hiring: Remote Psychologist Reviewer (ABA) - Kentucky Market** **Join Centene's mission-driven team as a… more
    Centene Corporation (05/11/25)
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  • Bariatric Clinical Reviewer

    Prime Healthcare (North Las Vegas, NV)
    …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/197871/bariatric- clinical - reviewer /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... patient guidance. The Coordinator is responsible for the administrative coordination of all clinical and support services for the program. As a member of the… more
    Prime Healthcare (03/04/25)
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