Clinical Review Nurse
Virtual Vocations Inc
To support the Home Health Services Team, the full-time Clinical Review Nurse will manage clinical staff oversight, ensure accurate documentation and coding, and implement educational initiatives, all while working remotely during day shifts. Key responsibilities Direct clinical staff through oversight of coding, care plans, and patient care provision Conduct initial medical record reviews within 24 hours of the SOC assessment for OASIS submission accuracy Develop and implement education initiatives to enhance documentation quality based on identified trends Required qualifications Bachelor's degree in Physical Therapy, Occupational Therapy, or a related area required Associate Degree in Nursing required Two years of clinical experience Experience in the Home Health environment preferred Current license (RN/PT/OT) required
- ...Job DescriptionJob DescriptionCLINICAL REVIEW NURSE - REMOTE ARC Group has multiple positions open for Clinical Review Nurses! These positions are 100% remote. These are direct hire FTE positions with salary, benefits, etc. This is a fantastic opportunity to join a dynamic...SuggestedPermanent employmentWork at officeLocal areaRemote work
- ...Assistance Program ~ Rewards and Recognition Programs ~ Paid Time Off and Paid Sick Leave Summary Statement The Clinical Review Nurse is responsible for reviewing and making medical determinations as to the validity of health claims and levels of payment in...SuggestedPermanent employmentTemporary workWork at officeLocal areaImmediate startRemote work
$17.37 - $28.95 per hour
...Job Category : Clinical Technical NonExempt Requisition Number : CLINI004151 Posted... ...95 General Summary: The Clinical Chart Review will serve as an adjunct to the patient’s... ...algorithm/process as predetermined by nursing management and provider Manage...SuggestedFull timeWork at office- ...Clinical Nurse ReviewerAs one of the fastest growing Independent Physician Associations in Southern California, our organization offers... ...our success.We currently have an opening for Clinical Nurse Reviewer. The Clinical Nurse Reviewer will specifically run analysis on...SuggestedWork experience placementFlexible hours
- ...Job Title: Clinical Review Nurse Address: Remote CST Job Description Perform concurrent reviews to determine members' overall health, appropriate care, and level of care. Review acuity, resource consumption, length of stay, quality and continuity of care, and discharge...SuggestedFull timeRemote workMonday to Friday
- ...schedule. Responsibilities: Perform concurrent reviews of members for appropriate care and... ...of care and medical necessity based on clinical policies and guidelines. Review member’s... ...: Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing. Minimum...Remote workWeekend work
- ...Job Title: Clinical Review Nurse - Concurrent Review - J00933 Address: Various, SC Job Description Perform concurrent reviews to assess members' overall health, medical necessity, and appropriate level and setting of care. Evaluate inpatient services, including...Full timeRemote workMonday to FridayWeekend work
$25 - $50 per hour
...medical devices, nutritionals and branded generic medicines. Our 122,000 colleagues serve people in more than 160 countries. Clinical Review Nurse Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your...Hourly payWork at officeMonday to Friday- ...Description Be the voice that helps patients navigate their cancer care journey. As a Clinical Review Nurse, you will serve as a critical link between providers, patients, and insurance carriers, ensuring treatment plans are reviewed efficiently and accurately....Shift work
- ...looking for motivated individuals who want to be part of our mission and join our team! As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise and judgement along with established medical criteria to perform first level clinical...Local area
$27.02 - $48.55 per hour
...Position Purpose: Performs concurrent reviews, including determining member's overall health... ...a minimum of two years of acute care nursing experience. Previous Utilization... ...of care and medically necessity based on clinical policies and guidelines Reviews member's...Hourly payFull timePart timeWork at officeRemote workMonday to FridayFlexible hours- ...Position Title: Clinical Review Nurse - Concurrent Review Work Location: Remote, Compact Nursing License Required, Central Time Zone Work Schedule Assignment Duration: 12-Month Contract to Hire Work Schedule: Mon-Friday, 11 AM to 8 PM CST; Weekends and Holidays...Contract workRemote workWeekend work
- ...Clinical Review Nurse – RN or LPN (Hybrid)Compensation and Benefits Salary: LPN/LVN: $80,000 – $85,000 RN: $107,000 – $115,000 Comprehensive BenefitsLocation: New York, NY Organization: Wonderful health plan organizationPosition Summary Reports to Team Lead, Clinical Quality...
- ...Jobs / Clinical Review Nurse - Concurrent Review - J00933 Clinical Review Nurse - Concurrent Review - J00933 Conduct concurrent reviews of patient care for quality and compliance.Collaborate with healthcare providers to ensure appropriate treatment plans.Analyze patient...
- ...FloMed Infusion is an outpatient infusion clinic offering Medical Infusions and Injections... ...on what we do and who we are, please review our website We are a Florida-based company... ...a Full-Time Clinical Review Registered Nurse to focus on incoming orders and documents...Hourly payFull timeWork at office
$40 - $43 per hour
...Job DescriptionJob DescriptionTitle: Clinical Review Nurse - Concurrent ReviewLocation: Remote - KentuckyPay: $40–$43 per hour, based on experienceSchedule Options: Monday–Friday, 8:00 AM–5:00 PM EST, with rotating weekend coverage (one weekend every 5–6 weeks, Saturday...Hourly payTemporary workRemote workMonday to Friday- ...Clinical Review Nurse - Concurrent ReviewPosition TitleClinical Review Nurse - Concurrent ReviewWork LocationRemote-OKAssignment Duration3 months (Possibility to extend or convert)Work ScheduleM-F 8-5 EST No OT approvedWork ArrangementRemoteResponsibilitiesUtilization...
- ...Position Title Clinical Review Nurse - Concurrent Review Work Location Remote-MS CST Assignment Duration 3 Months Contract to Hire Work Schedule 8 am-5 pm (Central). OT is voluntary; weekend rotation once every 2 months Work Arrangement Remote...Contract workRemote workFlexible hoursWeekend work
- ...Title: Clinical Review Nurse- Concurrent Reviews Location: Remote- KY or Compact state license Duration: 6 months with possible extension or conversion Schedule: Tues- Sat 8-5pm EST This is an every Saturday position and manager is open to 4-10 hour...Remote workShift work
- ...A healthcare organization is seeking a Clinical Review Nurse – Concurrent Review to perform utilization management functions remotely. The role requires conducting concurrent reviews, collaborating with medical teams, and ensuring quality healthcare outcomes. Candidates...Work at officeRemote work
$36 - $39 per hour
...Immediate need for a talented Clinical - Clinical Review Nurse - Concurrent Review. This is a 06+ Months Contract opportunity with long-term potential and is located in Louisville, KY (Onsite) . Please review the job description below and contact me ASAP if you are...Contract workLocal areaImmediate start$27.02 - $48.55 per hour
...Remote Prior Authorization Reviewer Position Purpose: Analyzes all prior authorization... ...break. Performs medical necessity and clinical reviews of authorization requests to... ...Education/Experience: Bachelor's degree in Nursing (BSN) or graduation from an accredited...Hourly payFull timePart timeWork at officeRemote workMonday to FridayFlexible hours$60.52k - $129.62k
...something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Clinical Nurse Reviewer will serve as the designated lead for STAR Kids rolling month state audit submissions. This role is responsible for the...Hourly payFull timeTemporary workLocal area$33.5 - $45 per hour
...-2 years of inpatient and SNF Concurrent review and discharge planning experience. To provide... ..., and BH. The case manager is a licensed nurse (RN or LVN). A care manager can be a... ...and contracts. * Review and process clinical information in accordance with regulatory...Hourly payFull time- ...Centene Corporation seeks a Nurse Reviewer to analyze prior authorization requests and determine medical necessity in line with regulatory guidelines and member benefits. You will collaborate with medical directors, providers, and the authorization team to ensure timely...Full timeRemote workMonday to Friday
- ...Position Title Clinical Review Nurse - Prior Authorization Work Location Remote; nationally sourced within approved U.S. states. Must be available during standard business hours for the assigned team. Assignment Duration 12 Months possibility of extension...Work at officeRemote workMonday to Friday
- ...Job DescriptionJob DescriptionOur client, a Health Insurance company, is looking for a Clinical Medical Review Nurse for their Columbia, MD/Hybrid location. Responsibilities:This role will support medical record retrieval, abstraction, pend management, overreads, and other...Work at officeShift work
- ...WNS, part of Capgemini, is seeking a Clinical Review Nurse for a fully remote, full-time role. You will perform prospective utilization reviews for HealthHelp’s programs, applying clinical guidelines and policies to decide medical necessity. Successful candidates will...Full timeRemote work
- ...Position: Clinical Medical Review Nurse Location: Columbia, MD - Hybrid - (Once/Twice in a Week Meeting in Office) Duration: 6+ Months Interview Mode: 2 Interviews (One Virtual and One In-person at Columbia Office) SKILLS : RN/LPN or Nursing, Clinical Medical Review, HEDIS...Work at officeShift work
- ...Job Description Job Description We are partnering with a healthcare organization seeking experienced Clinical Nurse Reviewers for a long-term engagement with the possibility of full-time conversion. This role focuses on conducting medical record reviews across multiple...Full timeContract workWork at office
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