Clinical Review Team Navigator
Henry Ford Health
Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford's care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation's most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. The Patient Billing and Financial Care Assistance (PBFCA) department at Henry Ford Health is dedicated to ensuring that all patients receive the care they need, regardless of their financial situation. Our team works collaboratively across the organization to address financial barriers, connect patients with available assistance programs, and ensure a seamless care experience. We are committed to providing compassionate, patient-centered support while maintaining the highest standards of integrity and efficiency. Role Overview As a Clinical Review Team Navigator, you will play a vital role in assisting the Clinical Review Team in screening patient care requests for medical necessity and urgency. You¿ll ensure financial responsibilities are addressed before services are rendered, advise patients on financial assistance programs, and collaborate with physicians and staff to determine continuing care needs. Your work directly supports uninsured, underinsured, and insured patients, ensuring they receive the care they need while navigating financial complexities. Why Henry Ford Health At Henry Ford Health, we are relentless advocates for exceptional care for our patients, communities, and each other. We come to do meaningful work and grow our careers, and we stay for the connection, support, and shared pride in making the impossible, possible. What You Will Do - Assist in screening patient care requests for medical necessity and urgency. - Ensure all financial responsibilities, including current and prior balances, are addressed before services are rendered. - Advise patients on available financial assistance programs. - Collaborate with physicians and Henry Ford Health staff to determine continuing care needs.
- Handle sensitive information with confidentiality, respect, and empathy in difficult interpersonal situations. Required: - High School Diploma or G. E. D. equivalent. - Two (2) years of experience working as a patient navigator, patient advocate, financial navigator, or insurance verification specialist. - Working knowledge of Microsoft Office Suite. - Technical proficiency in EPIC applications such as Appointment Scheduling (all versions), Registrations, Work Queues, and Referrals. - Ability to speak clearly and effectively. - Customer service-oriented with the ability to handle sensitive information/issues in a confidential, respectful, assertive, and empathetic manner. Preferred: - Associate's degree or two (2) years of college course-work in business, community health, social work, case management, or a related field. - Knowledge of medical terminology. Join a team where you can grow your career, collaborate with dedicated professionals, and contribute to mission-driven work that makes a real difference. We provide opportunities for continuous learning and professional development in a supportive and innovative environment. Join Our Team Ready to make a meaningful impact? Apply now to join Henry Ford Health as a Clinical Review Team Navigator!
$91k - $106.4k
...all applications and next steps. Our partner is looking for a Clinical Care Reviewer based in the United States. The Clinical Care Reviewer will... ...a nationwide care network. As part of the Clinical Quality team, you will coach clinicians individually, facilitate consultation...SuggestedRemote workHome officeFlexible hours- ...change in the field of mental healthcare. About the Role We’re seeking a Clinical Care Reviewer to help bring Rula’s care efficiency pilots to life as part of our Clinical Quality team. In this role, you’ll work directly with providers across our network, coaching...SuggestedFull timeLive inCurrently hiringRemote workHome office
$18.3 - $20 per hour
...Puerto Rico, our model combines clinical expertise, compassionate care... ...lives. As part of the Lucet team, employees join a mission-... ...Whether through behavioral health navigation, in-home medical care, or 24/... ...position will accept and review new applications and resumes...SuggestedHourly payRemote workWork from homeFlexible hours$20 - $25 per hour
...Job Title: Utilization Review Coordinator Reports To: Revenue Cycle Management Leadership... ...: As a key member of the Northpoint team, he Utilization Review Coordinator supports... ...tracking, payer correspondence, clinical documentation coordination, payer portal...SuggestedFull timeTemporary workRemote workMonday to Friday$65k - $75k
...Hone is an online medical clinic at the forefront of transforming... ...strongly about being part of a team that advocates for people to live... ...is looking for a RN Clinical Navigator to join our team. As someone... ...their medical care. You will review, triage, and escalate physician...SuggestedRemote jobFull timeTemporary workPart timeFor contractorsLive inFlexible hours$70 per hour
...Benefit Navigation Expert — Remote AI Benefits Review is a remote review track for evaluating AI outputs across benefit navigation specialist operations... ...risk; and document the right next step so the modeling team can train on it. Why this role matters Benefit Navigation...Remote jobFor contractorsWork experience placement10 hours per week- ...all applications and next steps. Our partner is looking for a Clinical Care Reviewer based in the United States. The Clinical Care Reviewer will... ...a nationwide care network. As part of the Clinical Quality team, you will coach clinicians individually, facilitate consultation...Remote work
$20 per hour
...experience with Cyber Incident Response. About the Role Document Review Analysts will review documents for Personal Identifiable... ...with document handling standards Communicate effectively with team members and project leadership Accurately track and input hours...Temporary workRemote workWork from homeHome officeMonday to Friday- ...Repository Navigation Workflow Reviewer is a remote evaluation track for reviewing repository navigation workflow evaluation prompts and responses... ...cases, and write the kind of structured feedback the modeling team can use to retrain. Why this role matters AI data...Remote jobHourly payFor contractors10 hours per week
$17.71 - $25.28 per hour
...striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all... ...and adherence to billing regulations Essential Functions -Review and assess medical claims submitted by healthcare providers, insurance...Hourly payFull timeWork at officeRemote workMonday to FridayFlexible hoursShift work- ...expertise and execution to create meaningful, measurable impact. The Clinical Review Nurse makes prospective medical necessity determinations on... ...reviews. - Collaborates with client personnel and internal teams to resolve concerns, and contributes to a team environment of...Hourly payFull timeWork at officeRemote work
$50 per hour
...~ Remote: open to US-licensed physicians based in eligible US states ~ No patient contact, no malpractice exposure: you review written clinical cases ~ All contributors are license-verified physicians ~$50 one-time onboarding reward, paid once your first task on...For contractorsRemote workFlexible hours$34 - $36 per hour
...National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Clinical Consultation Triage Team - Part Time Please note, this class starts on January 4th - no exceptions. As a nurse at Sedgwick, you can build...Part timeRemote work- ...Job Titile: Senior Manager, COMPASS Navigator Team Location: Remote About the Job... ...evaluate communication effectiveness. Case reviews - assessing whether CNs leveraged all... ...through the appropriate channels Clinical Review — Provide an additional clinical...Remote work
$89.54k - $136.47k
...Days) Overview: Sentara Health is hiring a Remote Utilization Review Registered Nurse. Candidates must reside in the State of... ...Responsible for written and /or verbal communication of pertinent clinical information. Education: · N-3 Years RN- Diploma (required) ·...Full timeTemporary workRemote workShift work- ...Overview Dane Street is seeking an experienced, licensed Dental Specialist to join our growing team of expert clinical reviewers. In this role, you will your specialized clinical knowledge and expertise in dentistry to conduct comprehensive reviews of dental records, clinical...For contractorsRemote work
- ...Clinical Trial Protocol AI Reviewer is a remote clinical-review track for evaluating AI outputs that touch clinical review. Reviewers grade differential... ...the corrected clinical reasoning so the modeling team can close the gap. Why this role matters Clinical review...Remote jobHourly payFor contractors10 hours per week
- ...reflects the strength of our partnerships and the commitment of our team. Our values bind us together and make us one. When one falls,... ...rise. Job Summary: SmithRx is looking for a motivated Senior Clinical Review Operations Pharmacist to serve as a clinical subject matter...Full time
- ...Overview Dane Street is seeking experienced, licensed Chiropractors to join our growing team of expert clinical reviewers. In this role, you will your chiropractic expertise to conduct comprehensive reviews of clinical cases and provide objective, evidence-based clinical...Full timeFor contractorsRemote work
- ...Description Dane Street is seeking experienced, licensed Chiropractors to join our growing team of expert clinical reviewers. In this role, you will your chiropractic expertise to conduct comprehensive reviews of clinical cases and provide objective, evidence-based medical...Full timeFor contractorsRemote work
- ...here. So will you. Ergomed is a specialist clinical research organization focused on rare... ...have built a collaborative, international team where people share ideas, grow their careers... ...clinical team (e. g. CRAs) - Develops, reviews and revises project documents (e. g. Clinical...Full time
$57.17k - $73.13k
Position: Care Navigator The Care Navigator is a patient-facing... ...integrated member of the pod care team, the Care Navigator addresses non-clinical barriers including housing instability... ...diagnose and treat health issues; review and prescribe medication; provide...Local areaImmediate startFlexible hours- ...About Lyra Lyra Clinical Associates partners with Lyra Health, a leading... ...published more than 35 peer-reviewed studies, and delivered... ...for a full-time Neurodiversity Navigator who is passionate about whole... ...health care to join our clinical team. This remote position reports...Full timeRemote work
$25 - $30 per hour
...Patient Navigator Location: Remote Employment Type: Part-time (20–25 hours per week), W2... ...already receive care. By integrating a virtual team of care managers, coaches, therapists, and psychiatric providers into clinical workflows, FamilyWell is expanding access to...Remote jobHourly payFull timePart time- ...Specialist plays an integral role in the review process as they are responsible for communicating... ..., company best practices, and clinical accuracy. In addition, the QA Specialist... ...Street’s success relies on individual and team contributions every day. We care for our...Full timeWork at officeWork from home
$67.68k - $75k
...outcomes through technology, services, and clinical expertise. Our mission is to innovate... ...outcomes – making this a great time to join our team of passionate individuals dedicated to... ...Acentra Health is looking for a Care Navigator to join our growing team. Job Summary:...Contract workWork at officeLocal areaFlexible hours$60k
...by deploying evidence-based clinical pathways and embedding technology... ..., and health plans to navigate the complexities and burden of... ...Flatiron, Oscar, Imagen). Our team includes startup veterans, physicians... ...caregiver and patient. Reviews needs, identifies goals, and...Remote jobFull timeLocal area- ...Experienced hospitalists review inpatient documents such as H&Ps, progress notes and discharge summaries for clinical accuracy and completeness. They settle conflicts between sources, label significant errors or omissions by severity, apply rubrics, and write brief rationales...Contract workRemote work
- ...the strength of our partnerships and the commitment of our team. Our values bind us together and make us one. When one... ...when one rises, we all rise. Job Summary: Joining SmithRx’s clinical team, the Clinical Review Pharmacist plays a key role in enhancing clinical...Full timeContract workFlexible hoursWeekend work
- ...innovation. Broadway Ventures has an opening for a Medical Reviewer. This team handles a variety of claim types including Radiology,... ...Physical Therapy and Surgical. Performs medical reviews using clinical/medical information provided by physicians/providers and established...Remote jobContract workTemporary workFor contractorsLive inWork at officeWork from home
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