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CLINICAL REVIEW NURSE I - MEDICARE PART B (US)

Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials. . Requires AS in nursing and minimum of 1 year of clinical experience; or any combination of...

CompanyElevance Health
AddressAtlanta, GA
CategoryInformation Technology
Date Posted 3 weeks ago See detail

Clinical Review Nurse I - Medicare Part B (US)

Elevance Health

Atlanta, GA

Assesses the necessity and reasonableness of the items supplied in a valid claim through the use of medical policy and other materials. . Requires AS in nursing and minimum of 1 year of clinical experience; or any combination of...

3 weeks ago seen See more...

Clinical Review Nurse - Prior Authorization

Bcforward

Indianapolis, IN

Clinical Review Nurse - Prior AuthorizationBC Forward is looking for Clinical Review Nurse - Prior Authorization (Remote Work) Position Title: Clinical Review Nurse - Prior Authorization (Remote Work) Locations: Remote IN (Local t...

2 months ago seen See more...

Medical Review Nurse New

Performant Financial Corporation

Remote

$59,500 - $78,000 a year

Auditing claims for medically appropriate services provided in both inpatient and outpatient settings while applying appropriate Medical Review guidelines, policies and rules. Document all findings referencing the appropriate poli...

18 hours ago seen

Registered Nurse Clinical Denials & Appeals Reviewer

Administrative Regional Training Cntr

Buffalo, NY

$36.19 - $54.29 an hour

Registered Nurse with a current New York State license Bachelor of Science Nursing degree Holds, or will obtain within one (1) year of hire, one of the following (or similar) credentials: Certified Documentation Specialist, Certif...

2 weeks ago seen See more...

Clinical Reviewer (Medical Coding Academy - CPC) - San Juan, PR

Optum

San Juan, PR

Clinical Case Reviews -75%Perform clinical review of professional (or facility) claims vs. medical records to determine if the claim is supported or unsupported.Maintain standards for productivity and accuracy. Standards are defin...

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Medical Review Nurse

Blue Cross Blue Shield Of Louisiana

Baton Rouge, LA

This role does not manage people. This job reports to: Departmental Leadership. Necessary Contacts: In order to effectively fulfill this position, the incumbent must be in contact with: Healthcare providers and subscribers to obta...

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Clinical Nurse Review - II

Progressive Technology Solutions

Owings Mills, MD

$35 - $39 an hour

8 hour shift. Owings Mills, MD 21117: Relocate before starting work (Required)....

3 weeks ago seen See more...

Primary Care Clinical Nurse Leader

Department Of Veterans Affairs

San Francisco, CA

Competitive

The Clinical Nurse Leader (CNL) applies the nursing process and care management principles within a collaborative and inter-disciplinary practice setting. Nursing staff are supported in the provision of complex patient care. The C...

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Wound Care Nurse Practitioner/Clinical Nurse Specialist

Department Of Veterans Affairs

Seattle, WA

Competitive

Assesses, plans, implements and evaluates care based on age-specific components. Assumes responsibility for the coordination of care focused on patient transition through the continuum of care, patient and family education, patien...

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Registered Nurse- Risk Manager Clinical Reviewer

Department Of Veterans Affairs

Martinsburg, WV

Competitive

Demonstrates knowledge in the interpretation and application of accrediting body standards and other agency requirements. Assists with monitoring of various aspects of care provided to Veterans and the analysis and interpretation...

a month ago seen See more...

Medical Review Nurse (MRAC)

Provider Resources, Inc.

Hartford, CT

Understand and represent PRI?s mission, vision, and values to all internal and external customers. Engage clients in appropriate communication that manages client expectations and builds a collaborative relationship with the clien...

2 days ago seen See more...

Clinical Nurse Specialist (CNS) - GEC Division

Department Of Veterans Affairs

Milwaukee, WI

Competitive

Clinical and educational needs of patients and staff. Provides direct patient care as appropriate. Provides leadership on unit-based, departmental and facility-wide Nursing and interdisciplinary committees, projects, and work grou...

5 days ago seen See more...

Pediatrics - Clinical Resource Nurse - Patient Access Specialist Inpatient

University Of Rochester

Rochester, NY

Required Visa Status:CitizenGCUS CitizenStudent VisaH1BCPTOPTH4 Spouse of H1BGC Green CardEmployment Type:Full TimePart TimePermanentIndependent - 1099Contract W2C2H IndependentC2H W2Contract Corp 2 CorpContract to Hire Corp...

2 days ago seen See more...

Clinical Research Nurse

Northwestern University

Chicago, IL

Conducts initial study visit. Verifies subject eligibility. Performs study procedures including collecting and processing specimens, physical exam including obstetrical exam, subject interview. Performs subject recruitment, includ...

2 days ago seen See more...

Clinical Nursing Director - Adult Services

Kaiser Permanente

Sacramento, CA

Collaborates with CNO and other medical center management in identifying and implementing innovative models and best practices with an emphasis on quality of care, service improvements and cost reduction. With TPMG partner, direct...

6 days ago seen See more...

Utilization Review Nurse, RN

Uf Health Central Florida

Leesburg, FL

Professional certification in CM preferred. Associate's degree required. Current Florida nursing license required. Must be able to read, write in, speak and understand English. Experience: Minimum of 5 years of clinical experience...

7 days ago seen See more...

Clinical Nursing Director - Adult Services

Kaiser Permanente

Santa Clara, CA

Collaborates with CNO and other medical center management in identifying and implementing innovative models and best practices with an emphasis on quality of care, service improvements and cost reduction. With TPMG partner, direct...

a week ago seen See more...

Clinical | Travel:Registered Nurse (RN) / Emergency Dept - Contract - Nights

Healthtrust

Corsicana, TX

Perform plan of care intervention, including medication administration, specimen collection, clinical treatments, and other medical care, documenting care given. Monitor, records, and communicate patient condition as appropriate t...

4 days ago seen See more...

Clinical Studies Report Reviewer

Sqa Services

Remote - Oregon, United States

Study Details Demographics Test Product Accuracy Study Plan Results Source verify data with source documents from CRO and master study file, protocol, and product information Any reporting on Adverse Events Deviations are clearly...

4 days ago seen See more...

Registered Nurse - Women's Health Clinical Care Coordinator

Department Of Veterans Affairs

Alexandria, LA

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

4 days ago seen See more...

Mobile Clinic Registered Nurse - East

Dap Health

Coachella, CA

$47.58 - $52.13 an hour

Establishes, interprets, and disseminates department policies and protocols to ensure uniform delivery of services and promotes quality assurance. Functions as a member of the interdisciplinary and nursing team. Works with Directo...

4 days ago seen See more...

Clinical Research Nurse (LVN/LPN) (On-Site, Jefferson City, MO)

Iqvia

Jefferson City, MO

Provides Clinical Research support to investigators to prepare for and execute assigned research studies Reviews study protocols, source document forms, other study-specific documents, and electronic data capture systems used to r...

5 days ago seen See more...

Clinical Nurse-SpineCenter-8C-Mount Sinai Hospital-FT/Days

Mount Sinai

United States

Delivers patient care by incorporating the tenets of the professional practice model of Relationship Centered Care and through the application of the nursing process based upon theory, research, evidence-based practice, and appro...

2 weeks ago seen

Registered Nurse Specialty Clinics

Department Of Veterans Affairs

Loma Linda, CA

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

5 days ago seen See more...

Nurse Manager (Surgical Service Clinic)

Department Of Veterans Affairs

Loma Linda, CA

Competitive

U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are su...

5 days ago seen See more...

Clinical | Travel:Registered Nurse (RN) / ICU - Contract - Nights

Healthtrust Workforce Solutions

Valparaiso, IN

Perform plan of care intervention, including medication administration, specimen collection, clinical treatments, and other medical care, documenting care given. Monitor, records, and communicate patient condition as appropriate t...

6 days ago seen See more...

Clinical | Travel:Registered Nurse (RN) / ICU - Contract - Nights

Healthtrust

Bullhead City, AZ

Perform plan of care intervention, including medication administration, specimen collection, clinical treatments, and other medical care, documenting care given. Monitor, records, and communicate patient condition as appropriate t...

6 days ago seen See more...

Clinical | Travel:Registered Nurse (RN) / Medical Surgical - Contract - Nights

Healthtrust

Roswell, NM

Perform plan of care intervention, including medication administration, specimen collection, clinical treatments, and other medical care, documenting care given. Monitor, records, and communicate patient condition as appropriate t...

6 days ago seen See more...

Surgery Clinic Nurse Manager- Pre-Operative Nursing Service

Department Of Veterans Affairs

Las Vegas, NV

Competitive

Planning work to be accomplished by subordinates, setting priorities and preparing schedules for completion of work. Assigning work to assigned personnel based on priorities, selective consideration of the difficulty and the requi...

2 weeks ago seen See more...

Licensed Practical Nurse TeleHealth Outpatient Clinic

Department Of Veterans Affairs

Phoenix, AZ

Competitive

Communicates regularly with nurse managers, physicians, nursing supervisors, charge nurses, allied healthcare staff, healthcare technicians, pharmacists, social workers, dietitians and team members. Document patients' responses to...

a week ago seen See more...

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What are the top cities open Contract Clinical Review Nurse jobs?

There are open Contract Clinical Review Nurse jobs in several cities including New York, Chicago, Houston, Dallas, Salt Lake City, Phoenix, Portland, Indianapolis, Marrero, Iselin, Hialeah, Owings Mills,

What companies are hiring for Contract Clinical Review Nurse jobs?

The top companies hiring now for Contract Clinical Review Nurse jobs are Novitas - 2.7, Progressive technology solutions,

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