Clinical Documentation Specialist - Utilization Management (Full-Time, Days)
$51.76 - $69.88 per hourEnloe Health
ENL Utilization Management Compensation range: $51.76 - $69.88 Your rate of pay will be based on applicable experience Shift: Days Shift length: 8 Hours Days off: Saturday & Sunday Hours per pay period: 80 Hours Enloe Health is a Level II Trauma Center located in beautiful Northern California. We offer a full array of medical services, and our mission is to elevate the health of the communities we serve. As a Planetree organization, we place high value on hiring the right team to care for our patients and their families—care that is steeped in compassion, human connection, and mutual support. If you feel called to make a meaningful impact through empathetic, person-centered care, and thrive in a culture that values collaboration and purpose, we welcome you to join our team. POSITION SUMMARY The Clinical Documentation Specialist (CDS) is responsible for reviewing medical records to facilitate the accurate representation of the severity of illness. This involves the extensive record review, interaction with physicians, clinical staff, and HIM professionals. Utilizing advanced clinical knowledge, the CDS role requires the ability to review the medical record accurately and timely, recognize opportunities for documentation improvements, formulate clinically credible documentation clarifications, follow-up timely on all cases, especially those requiring clinical documentation clarifications, and communicate effectively and appropriately with the physicians. The CDS participates in the Task Force Meetings and collaborates on developing education for medical staff. EDUCATION / TRAINING / EXPERIENCE Minimum: Five years inpatient acute care nursing experience Desired: CDI Experience Critical Care Experience Bachelor's or Master's degree, in nursing Experience in hospital operations, management and physician relations LICENSES / CERTIFICATIONS Minimum: Current licensure with the California Board of Registered Nursing Current CPR certification CCDS Certification (or must obtain when eligible to test) (dept tracks) SKILLS / KNOWLEDGE / ABILITIES Must have excellent verbal and written communication skills and advanced critical thinking skills and be able to maintain strong, positive working relationships with medical staff. Understands and supports the CDI documentation strategies and concepts. Demonstrates advanced clinical expertise including understanding of nursing anatomy/pathophysiology, disease processes, pharmacology, advanced critical thinking, deductive reasoning and problem solving skills. Demonstrates organizational, analytical and interpersonal skills. Requires strict HIPPA compliance. Demonstrates ability to interact with a wide variety of individuals and handle multiple priorities. Proficiency in computer use, including database programs, presentation programs, word processing and internet search. Ability to work independently, be self-motivated, and adaptable to changes in work environment. Must be able to interact professionally with various colleagues and foster a team environment. Must be able to perform the essential functions of the position. BENEFITS INFORMATION $0 premium medical plan to include vision insurance Prescription and dental group insurance Retirement with employer match Generous paid time off (PTO) plan that starts accruing immediately and can be used as it's earned Extended Sick Leave Flexible Spending Accounts for unreimbursed medical expenses and dependent care Employee Assistance Program Educational Assistance #J-18808-Ljbffr Enloe Health
- ...Northern California is seeking a Clinical Documentation Specialist (CDS) to review medical records and... ...to ensure accurate coding and timely follow-up. The ideal candidate has... ...experience, and RN licensure. This full-time role offers day shifts, competitive pay, and...Full timeDay shift
$62k - $65k
...Location: Remote Type: Full-Time Rate: $62-$65K About... ...opportunities with expert program management, cutting-edge... ...hire people who bring clinical rigor, sound judgment,... ...Provide clear, well-documented rationales supporting... ...disabilities. Broadway Ventures utilizes the OFCCP-approved...Full timeRemote jobContract workTemporary workFor contractorsWork experience placementLive inWork at office- ...system and provide a full spectrum of... ...hiring for a Full-time Inpatient Hospital... ...and coordinates with Management, CDI and HIM on coding documentation. Provides support to... ...skills and able to utilize a computerized encoder... ...AHIMA Certified Coding Specialist (CCS) - AHIMA...Full timeCurrently hiringRemote work
$21.65 - $30.03 per hour
...application process. Clinical Certified Medical Assistant/LPN Full Time Main, Salem, OR, US 30+ days ago Requisition ID:... ...Athletic & Weight Management Club Credits ~... ...in medical record documentation and recording test... ...skills. Ability to utilize computer programs...Full timeHourly payPart timeWork at officeFlexible hours$23 - $27 per hour
...DescriptionThis is a full-time, 40 hour/week... ...role: The Clinical Associate is... ...specialty networks, managing electronic... ...end of the day, your goal in... ...electronic results and documents to ensure... ...in-network specialists and obtaining... ...settings. Experience utilizing Electronic...Full timeContract workInternshipShift work- ...will be responsible for managing the billing process,... ...coding, and facilitating timely payments from insurance... ...and insurance policies. Utilize medical office systems... ...such as denial rates and days in accounts receivable.... ...readiness. Job Types : Full-time, Employee or...Full timeHourly payContract workFor contractorsWork at officeTrial period
$75k - $90k
...application process. Clinical Reviewer -... ...OR Care Management F-T Reg 40 hrs... ...OR, US 30+ days ago Requisition... ...at the right time? In this role... ...review clinical documentation to determine... ...based criteria to utilization management... ...~2 years of full-time substance...Full timeContract workRemote workWork from home- ...Oak Street Health is seeking a Utilization Management Physician Reviewer for a fully remote, full-time role. You will render timely coverage determinations for inpatient... ...and outpatient services using UM criteria and clinical judgment, coordinating with care teams to...Full timeRemote work
$37.2 - $50.4 per hour
...Utilization Management NurseWork from home within Oregon, Washington... ...For: Every day, Cambia's dedicated team... .... As a member of the Clinical Services team, our Utilization... ...at least 3 years (or full time equivalent) of direct... ...with health care documentation systems. Strong...Full timeWork at officeImmediate startWork from homeFlexible hours$66.83k - $124.3k
...of a partner company, who manages all applications and next steps... ...partner is looking for a Clinical Documentation Specialist I based in the United... ...clarification requests. Conduct timely follow-up reviews of active... ...insurance available from the first day of employment. Financial...Remote work- ...Strategies, Inc. is seeking a Utilization Management RN to work from a home office. This full-time role runs Monday to Friday, 9am... ...RN will perform telephonic clinical assessments, collect information... ...and outpatient services, and document outcomes in the system. A valid...Full timeRemote jobWork from homeHome officeMonday to Friday
- ...: 2026-11-30Position Title: Utilization Management Rep I (US)Job Description: Job... ...to work virtually full-time, except for required in-person... ...requests. Refers cases requiring clinical review to a Nurse reviewer.... ...through 11:59:59 PM on the day before the listed end date....Full timeContract workTemporary workWork at officeLocal areaShift work1 day per week
- Oncology Clinical Data Abstractor (Contract, Remote)... ...Abstraction Review clinical documentation to abstract key... ...accurate, complete, and timely submission of curated... ...AI-enabled platform to manage a daily queue of records... ..., Chat, Sheets) for day-to-day communication and...Remote jobContract workImmediate startWorldwide
- ...opportunities with expert program management, cutting-edge... ...medical reviews using clinical/medical information... ...clinical guidelines. Documents decisions using indicated... ...of medical claims and utilization practices. Max Salary... ...access clearance in a timely manner. Preferred...Remote jobContract workTemporary workFor contractorsLive inWork at officeWork from home
- ...226 - Keizer, OR: Full time: Posted Yesterday:... ...of preventive care clinics and eight... ..., text) the prior day, and make necessary... ...the Hospital Office Manager and Hospital Leader... ...clients, veterinary specialists, and companies that... ...that the practice utilizes.Petco Animal Supplies...Full timeOdd jobWork at officeLocal areaImmediate startFlexible hoursNight shift
$83.69 - $180.25 per hour
...and one community at a time.Company: Oak Street HealthTitle: Utilization Management Physician ReviewerLocation... ...: Fully RemoteHours: Full-Time, Monday - Friday,... ...management (UM) criteria, clinical judgment, and internal... ...service requests and document the rationale for the decision...Full timeHourly payLocal areaMonday to Friday- ...together. Patient Revenue Management OrganizationPursue your passion... .... Code medical records utilizing ICD-10-CM and CPT-4 coding conventions... .... Review medical record documentation and accurately code the... ...Hospital Coding Certified Coding Specialist (CCS) Hospital Coding...Remote workRelocation package
- Utilization Management RN (M-F FROM YOUR HOME OFFICE) HealthCare StrategiesDescriptionDo... ...in their industry?F/T 40-hour/week... ...of personal and clinical information on... ...of Case Management. Document each call completely,... ...within the appropriate time frames. Provide educational...Full timeRemote jobWork at officeHome officeMonday to Friday
$65k - $88.6k
...Kentucky is seeking a Utilization Management Behavioral Health... ...support the coordination, documentation, and communication of... ...: Licensed Masters Clinical Social Worker ( LCSW... ...AM - 5:00 PM Eastern Time (ET). Travel: Travel... ...base pay for full time (40 hours per week...Full timeTemporary workApprenticeshipPrivate practiceWork at officeRemote workWork from homeHome office- ...paperwork for inclusion on the patient chart. Scans all appropriate documents into scanning system for retrieval as necessary. Demonstrates... ...Work Shift Schedule: Monday - Friday. 8 hour shift. Start time between 8:00am - 8:30am. Cedars-Sinai is a leader in providing...Full timeRemote workMonday to FridayShift work
- ...partner company, who manages all applications... ...Case Manager - Utilization Review Specialist based in the... ...compliance with clinical and payer requirements... ...initiatives, timely appeal... ...Review clinical documentation and claim histories... ...Benefits Remote work: Full-time remote work...Full timeLive inRemote work
- ...resolutions. The role prefers an active RN license (New York State license preferred), a BSN or CCM, and 2+ years in acute care, utilization management, or appeals. Familiarity with MCG/InterQual criteria and Medicaid/Medicare regulations is advantageous. #J-18808-Ljbffr...Remote job
- ...The role includes working from home within a defined US radius and involves documenting decisions with established criteria. Preferred candidates have BSN and additional clinical and utilization review experience, plus proficiency in MS #J-18808-Ljbffr Broadway...Remote jobWork from home
$61.6k - $77k
...position is responsible for managing and growing patient... ...sales pipeline, and ensure timely testing and repeat utilization. This role blends customer... ..., addressing logistical, clinical coordination, and service... ...challenges. Maintain accurate documentation of interactions,...Immediate startRemote workWorldwide- ...301 Department: Care Management Position Type: Full time, 40 hours/week, Non-Exempt... ...: 8:00 am - 4:30 pm, days are aligned with business... ...identify high-risk needs, guide utilization and initiate discharge... ...care plans. Use clinical judgment to manage complex...Full time
$46.92k
...married couples to serve as Full-time Flex Houseparents. In this unique... ...and mentorship * Managing household routines and student... ...schedule of nine consecutive days on duty, followed by three days... ...housing, meals while on duty, utilities, and more) * Comprehensive benefits...Full timeWork from homeRelocationRelocation packageFlexible hoursWeekday work$44.35 - $68.86 per hour
...Providence is calling for Senior Prospect and Systems Management Analyst - Philanthropy - Full time, Day Hybrid This position strategically supports the... ...all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across...Full timeMinimum wageLocal areaShift work$26.01 - $56.14 per hour
...and one community at a time. Position Summary Utilization Management is a 24/7 operation and... ...evening hours. Utilizes clinical experience and skills in... ...and computer generated documents as well as a PC monitor.... ...Weekly Hours 40 Time Type Full time Pay Range The...Full timeHourly payTemporary workWork at officeLocal areaWork from homeAfternoon shift$61k - $101k
...Job Family : CDI Specialist Travel Required :... ...comprehensive secondary clinical chart reviews to... ...for documentation clarification. Collaborates... ...Auditors, Case managers, Quality... ...is present at the time of discharge for... ...response to query (utilizing the following AHIMA...Temporary workImmediate startFlexible hours- ...Job Summary The Clinical Documentation Specialist (CDS) performs clinical documentation... ...documentation practices. Utilizes approved physician query processes... ...accurate reports in a timely manner, maintaining up-to-... ..., Health Information Management, or a related field preferred...Remote work
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