- Novo Nordisk Inc. (Boston, MA)
- …Inform health system decision makers, influencers and stakeholders hospital faculty, medical students, residents, interns as well as attending physicians, nurse ... by not exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications Bachelor's or equivalent degree, and/or Pharm… more
- Novo Nordisk Inc. (San Mateo, CA)
- …Externally, the DCS maintains relationships with physicians, physician assistants, nurse practitioners, medical assistants, pharmacists, nurses and other ... Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to identify… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …TeamAs an integral part of the Appeal Review team, the Clinical Appeals Nurse Reviewer will serve as a liaison and business expert for member and ... your true colors to blue. The RoleThe Clinical Appeals Nurse Reviewer is responsible for applying sound...the Physician Review Units to assist with medical necessity determinations. Key Qualifications: + Registered Nurse… more
- Elevance Health (Cerritos, CA)
- **RN Nurse Reviewer I - California** Location: **Virtual** - This role enables associates to work virtually full-time, with the exception of required in-person ... pm (PST) and with occasional weekend coverage.** The **RN Nurse Reviewer I** is responsible for conducting...reviews that are routine having limited or no previous medical review experience requiring guidance by more… more
- Elevance Health (Nashville, TN)
- ** Nurse Reviewer I** **Location:** **Virtual:** This role enables associates to work virtually full-time, with the exception of required inperson training ... an accommodation is granted as required by law. The ** Nurse Reviewer I** will be responsible for...reviews that are routine having limited or no previous medical review experience requiring guidance by more… more
- Commonwealth Care Alliance (Boston, MA)
- …for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer ... CCA-Auth & Utilization Mgmt **Position Summary:** Reporting to the Manager Utilization Management, the Nurse Utilization Management (UM) Reviewer is responsible… more
- City of New York (New York, NY)
- …health standards for children in foster care. The New Admissions Focused (NAF) Nurse Reviewer will be responsible for: 1. Scheduling and conducting NAF ... services for children newly admitted to foster care - Review medical records at ACS's contracted agencies...subject of a child abuse and maltreatment report. STAFF NURSE - 50910 Qualifications 1. A valid New York… more
- AdventHealth (Orlando, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...value you'll bring to the team:** + Reviews concurrent medical record for documentation compliance including completeness and accuracy… more
- AdventHealth (Altamonte Springs, FL)
- …collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...you will bring to the team:** . Reviews concurrent medical record for documentation compliance including completeness and accuracy… more
- Catholic Health (Buffalo, NY)
- …Yes Work Schedule: Days Hours: 8:00am-4:00pm Summary: Conducts audits of medical records within defined guidelines to ensure compliance with State/Federal and ... York State RN license + Valid drivers license EXPERIENCE + 3-5 years Medical Surgical experience required. + 3-5 years Home Care clinical experience preferred (CHHA,… more
- Lee County Board of County Commissioners (Fort Myers, FL)
- Transportation Plan Reviewer Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/5007029) Apply Transportation Plan Reviewer Salary ... Description Lee County is seeking a skilled and detail-oriented Transportation Plan Reviewer to join the Department of Community Development in the Development… more
- Hartford HealthCare (Hartford, CT)
- …than 30 different specialties. The primary responsibility of the Metabolic and Bariatric Surgical/ Medical Clinical Reviewer (MBSCR) is to ensure the accurate and ... And this is *your moment.* **Job:** **Administrative* **Organization:** **Hartford HealthCare Medical Group Specialists* **Title:** *Surgical Clinical Reviewer -… more
- Lee County Board of County Commissioners (Fort Myers, FL)
- Site Plan Reviewer Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/5015210) Apply Site Plan Reviewer Salary $26.92 - $36.06 Hourly ... for administering the Lee County Land Development Code and coordinating the review and analysis of applications for development orders, limited development orders,… more
- Cook Medical (West Lafayette, IN)
- … Medical Reviewer to join our growing Scientific Communications/Clinical team. Medical Reviewers provide medical review of documents written by team ... 9-to-5 Eastern Standard Time schedule (Monday through Friday). Responsibilities Provide medical review of clinical and certain regulatory documents (including… more
- Centers Plan for Healthy Living (Margate, FL)
- …For Healthy Living is currently accepting applications for Full Time Registered Nurse without experience. The Utilization Management Clinical Reviewer works ... in their home to improve their quality of life. Utilization Management Clinical Reviewer will assess and process all authorization requests to determine medical … more
- Magellan Health Services (Honolulu, HI)
- …services related to mental health and substance abuse treatment to ensure medical necessity and effectiveness. + Provides telephone triage, crisis intervention and ... of treatment when requests for services do not meet medical necessity criteria. + Participates in network development including...Job Information Title HMSA Care Manager - BH, UM Reviewer - Remote Hawaii Grade 24 Work Experience -… more
- Kelly Services (Plainsboro, NJ)
- **Pharmacovigilance QC Reviewer II** Location: Plainsboro, NJ Schedule: Hybrid role with at least 3 days/week onsite is expected Length 1 year Pay: 28:00 **Job ... Level: Minimum Bachelor's degree, HCP degree is required eg, pharmacist or nurse ; advanced degree preferred * Experience Level: 3+ Years of in Pharmacovigilance… more
- SSM Health (MO)
- …experience + Graduate of accredited school of nursing, PA, NP, or medical school, or Associate's degree and Certified Clinical Documentation Specialist (CCDS) ... the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group (DRG) assignment, risk of mortality (ROM), and severity of… more
- SUNY Upstate Medical University (Syracuse, NY)
- …quality review process. Supports the Attorney General's office in the review and defense of medical malpractice actions brought against the state. ... the Patient Relations department with patient complaints that require quality review and/or Risk oversight. Minimum Qualifications: Registered Nurse , NYS… more
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** Registered Nurse - Acute/ Medical (with Med /Surg Residency option) **Cost Center:** ... Repayment Program. To learn more about program eligibility, application process and expectations please review the Nurse Corp Loan Repayment page: Apply to the … more
