- Novo Nordisk Inc. (San Francisco, CA)
- About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... and developing and implementing regulatory strategies with the FDA to providing medical education and collecting data to support efficacy and new product… more
- Daiichi Sankyo, Inc. (Bernards, NJ)
- …pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and ... Field Reimbursement Managers, Field Sales Forces, Marketing, Oncology Clinical Nurse Educators, Oncology Market Alliances and other appropriate stakeholders. The… more
- Merck & Co. (North Wales, PA)
- …may include:- Health care providers such as physicians, physician assistants, nurse practitioners, nurses, pharmacists as well as quality directors and office ... at product workshops and conferences, as well as consistent and ongoing review of Company promotional materials. Providing Company management with updates on… more
- Novo Nordisk Inc. (Chicago, IL)
- …Externally, the DCS maintain 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
- 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
- Idaho Division of Human Resources (Twin Falls, ID)
- Nurse Reviewer - MED Posting Begin Date: 2025/06/09 Posting End Date: 2025/07/07 Category: Nursing Work Type: Full Time Remote: Flexible Hybrid Location: ... Registered Nurse ? The Idaho Department of Health and Welfare is recruiting for a Nurse Reviewer (Registered Nurse , Senior RN) position in our Bureau of… more
- HCA Healthcare (Houston, TX)
- …set us apart from any other healthcare provider. We are seeking a(an) Registered Nurse Clinical Reviewer to join our healthcare family. **Benefits** The Woman's ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no...passion for patient care. Apply today for our Registered Nurse Clinical Reviewer opportunity. **Job Summary and… more
- Elevance Health (Las Vegas, NV)
- ** Nurse Reviewer I** This role enables...reviews that are routine having limited or no previous medical review experience requiring guidance by more ... and ensures essential face-to-face onboarding and skill development. The ** Nurse Reviewer I** is responsible for conducting...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial … 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
- Elevance Health (San Juan, PR)
- …providing information technology and business operations services for health plans._ ** Nurse Reviewer I** **Location:** This role requires associates to ... but must be flexible according to business needs. The ** Nurse Reviewer I** is responsible for conducting...meets medical necessity criteria or requires additional medical necessity review . + Conducts initial … more
- HCA Healthcare (Conroe, TX)
- …next step in your career path, we encourage you to apply for our Registered Nurse Clinical Reviewer opening. We review all applications. Qualified candidates ... Do you have the career opportunities as a(an) Registered Nurse Clinical Reviewer you want in your...colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no… more
- Lee County Board of County Commissioners (Fort Myers, FL)
- Plan Reviewer Print (https://www.governmentjobs.com/careers/leecounty/jobs/newprint/4918314) Apply Plan Reviewer Salary $31.25 - $45.67 Hourly Location Fort ... Department is seeking a qualified individual to fill the position of Plan Reviewer . The Plan Reviewer will be responsible for reviewing residential and/or… 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
- HCA Healthcare (Pasadena, TX)
- …and Qualifications** The RN Clinical Reviewer conducts a comprehensive current review of clinical documentation within the medical record to achieve, ... or if additional documentation is necessary. + Performs the medical record review for conflicting, imprecise, incomplete,...growth, we encourage you to apply for our Registered Nurse Case Manager opening. We promptly review … more
- Independent Health (Buffalo, NY)
- …The Clinical Reviewer will be responsible for the collection and review of medical records specific to quality complaints/grievances and appeals as ... document research of initial coverage determinations, and lead coordination of clinical review with appropriate internal stakeholders and Medical Director. This… more
- Magellan Health Services (Albuquerque, NM)
- …according to medical necessity criteria. General Job Information Title Clinical Reviewer III, Behavioral Health - Albuquerque, NM Grade 26 Work Experience - ... + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results...Professional Clinical Counselor - Care Mgmt, RN - Registered Nurse , State and/or Compact State Licensure - Care Mgmt… 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
- ManpowerGroup (Columbia, SC)
- …to effectively communicate with members and healthcare providers. **Key Responsibilities** ✔ ** Medical Review & Utilization Management (80%)** + Perform ... Teams **Job Overview** We are seeking a **Utilization Management Nurse or Licensed Social Worker** to perform medical...medical reviews using established criteria and guidelines. + Review medical claims and determine reasonable charge… more
