Clinical Review Nurse - UM & Post-Appeals (RN)
$29.05 - $67.97 per hourMolina Healthcare of Illinois
Molina Healthcare is seeking a dedicated clinician for a role focused on medical claims review in Albuquerque, New Mexico. The position demands at least 2 years of clinical nursing experience and an active RN license. Responsibilities include reviewing documentation for medical necessity, facilitating appeals, and validating claims. The role offers a competitive pay range of $29.05 - $67.97 per hour, along with a comprehensive benefits package. Ideal candidates will possess strong analytical and communication skills, along with a deep understanding of coding practices. #J-18808-Ljbffr
$29.05 - $67.97 per hour
...Summary Utilizing clinical knowledge and experience... ..., responsible for review of documentation... ...review of appeals for denied prior authorizations... ...2 years clinical nursing experience,... ...Registered Nurse (RN). License must be... ...compensation may vary from posting based on...SuggestedHourly payWork experience placementWork at office$29.05 - $67.97 per hour
...Summary Utilizing clinical knowledge and... ..., responsible for review of documentation to... ...concurrent review of appeals for denied prior authorizations... ...2 years clinical nursing experience,... ...Registered Nurse (RN). License must be... ...may vary from posting based on geographic...SuggestedHourly payWork experience placementWork at office- ...This role requires that the employee is an active RN and based in Alabama. The Supervisor, Clinical Review plays a critical role in providing operational supervision... ...clinical criteria. Minimum Qualifications All nurse reviewers will be located and licensed within...SuggestedContract workRemote work
- ...About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that... ...completion of the Annual Standing Order Review and Internal Classification of Disease (... ...experience. Graduate of an accredited School of Nursing (RN). Current appropriate state licensure....SuggestedFull time
- ...University has an opening for **Adjunct Clinical and Lab Nursing faculty members,** and we invite... ...unencumbered, and multi-state (compact) RN license* Must successfully pass a drug... ...and faculty candidates will be asked to review GCU’s or expectations as part of the application...SuggestedWork experience placementReliefImmediate start
$105k - $110k
...Apply for this Job Click Here Hospice Clinical Director (RN) Albuquerque, New Mexico Full-Time... ...organization is seeking an experienced Registered Nurse leader to join its team as a Clinical... ...interdisciplinary team meetings to review patient care plans and coordinate care...Full timeRelocation packageMonday to Friday$1,733 per week
...Registered Nurse (RN) | Utilization Review Location: Albuquerque, NM Agency: GQR Healthcare Pay: $1,733 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position TravelNurseSource is working with...Hourly payWeekly payFull timeContract workImmediate startShift work$1,733 per week
...Registered Nurse (RN) | Utilization Review Location: Albuquerque, NM Agency: GQR Healthcare Pay: $1,733 per week Shift Information: Days Contract Duration: 13 Weeks Start Date: ASAP About the Position Case Manager RN Job Location...Hourly payWeekly payFull timeContract workImmediate startShift work- ...Description About the Role As a Home Health Clinical Manager (RN) , you step into a leadership role that... ...of a home health agency — guiding nurses and interdisciplinary staff, ensuring quality... ...competency and performance standards Review and guide individualized patient care...
$2,157 - $2,479 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Albuquerque... ...the support of a dedicated clinical team. Required... ...interventions, and monitors immediate post-procedure recovery. Working... ...to procedures, including reviewing medical history and performing...Full timeContract workTemporary workImmediate startShift work$2,556 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Albuquerque, NM Agency: Atlas MedStaff Pay: $2,556 per week... ...Great Recruiters. Both of those recognitions are fueled by real reviews by real travel nurses and allied healthcare professionals that...Hourly payFull timeContract workWork at officeRemote workShift workWeekend work$2,157 - $2,479 per week
...Registered Nurse (RN) | Cardiac Catheterization Lab Location: Albuquerque... ...the support of a dedicated clinical team. Required... ...interventions, and monitors immediate post-procedure recovery. Working... ...to procedures, including reviewing medical history and performing...Full timeContract workTemporary workImmediate startShift work- ...while maintaining cost-effective clinical operations in accordance with... ..., including performance reviews, disciplinary action and terminations... ...of Initial and Annual Nursing assessment, and ongoing evaluation... ...various levels of Home Therapies RN, Home Therapies LPN, HT...Full timeTemporary workWork at office
- ...Grand Canyon University has an opening for Adjunct Clinical Nursing faculty members, and we invite applications from individuals who are enthusiastic... ...~ An active, current, unencumbered, and multi-state (compact) RN license ~ Must successfully pass a drug test and competency...Work experience placementReliefImmediate start
$1,501 - $1,650 per week
...Registered Nurse (RN) | Intensive Care Unit (ICU) / Critical Care Location: Albuquerque... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore the... ...matching after 6 months · 24/7 support · Clinical support throughout your assignment 300...Full timeContract workLocal areaImmediate startShift workNight shift$1,500 - $1,750 per week
...Registered Nurse (RN) | Intensive Care Unit (ICU) / Critical Care Location: Albuquerque... ...failure, multisystem organ dysfunction, and post-surgical conditions • Interpret cardiac... ...share your updated resume for a quick review and consideration. Thanks & Regards,...Weekly payFull timeContract workImmediate startShift workNight shift- ...of care. Klarus Home Health is seeking a skilled and motivated RN Clinical Manager for our Albuquerque, NM growing home health office,... ...Do Provide clinical leadership and oversight for home health nursing teams Ensure OASIS accuracy, timeliness, and Medicare compliance...Temporary workWork at office
- ...Registered Nurse (RN) | Case Manager Location: Albuquerque, NM Agency: job.com... ...strong discharge planning, utilization review, care coordination, and communication skills... ...Dedicated Humans Powered by Smart Tech Why Clinical Staff Choose Job.com Healthcare? At...Weekly payFull timeImmediate startMonday to FridayShift workWeekend workDay shift
$2,006 - $2,159 per week
...Registered Nurse (RN) | Case Manager Location: Albuquerque, NM Agency: Host Healthcare... ...Satisfaction by MIT Sloan Management Review. No matter if you want to explore the... ...after 6 months · 24/7 support · Clinical support throughout your assignment 300...Full timeContract workLocal areaImmediate startShift work$1,841 - $2,045 per week
...Registered Nurse (RN) | Case Manager Location: Albuquerque, NM Agency: All Medical... ...~ Case Management or Utilization Review Certification - Highly Preferred Benefits... ...nursing, travel therapy, allied health, and clinical laboratory professionals from coast-to-...Weekly payFull timeContract workLocumImmediate start$1,841 - $2,045 per week
...Registered Nurse (RN) | Case Manager Location: Albuquerque, NM Agency: All Medical... ...~ Case Management or Utilization Review Certification - Highly Preferred Benefits... ...nursing, travel therapy, allied health, and clinical laboratory professionals from coast-to-...Weekly payFull timeContract workLocumImmediate start$45 per hour
...REJUVENATING MEDSPA Registered Nurse — Aesthetic Nurse... ...requires more than clinical skill — it requires a particular... ..., medical history review, and informed consent... ...skincare regimens, and pre/post-care instructions ◦ Maintain... ...• Current, unencumbered RN license in New Mexico (...Full timePart timeRelief$76.96k - $93.6k
...the Infection Preventionist, RN role at Genesis 2 days ago Be... ...Preventionist (IP) is responsible for the nursing center's Infection Prevention... ..., and length of service. Posted Salary Range USD $76,960.00 -... ...ago Registered Nurse - Peer Review Coordinator Registered Nurse -...Full timeTemporary workFlexible hoursShift workNight shiftAfternoon shift- ...A healthcare organization is seeking a Clinical Review Supervisor based in Alabama. The role requires an active RN license and involves supervising clinical staff for utilization reviews while ensuring compliance with healthcare standards. Candidates should have at least...
$45 - $50 per hour
...Registered Nurse (RN) Charge/Team Lead - Albuquerque, NM Family Medicine Clinic | Outpatient & Mobile Care At Health by Design... .... VIEW COMPLETE JOB POSTING AT True work/life... ...the hiring process, such as reviewing applications, analyzing resumes...Full timeImmediate startMonday to FridayShift workWeekday work$46 per hour
...environment. Our Senior RN-Case Managers Direct... ...and with state-specific nurse practice act, and... ...Serve as a local on-site clinical resource as needed and provides... ...validation Review and evaluate clinical documentation... ...of staffing cases post referral Equipment tracking...Hourly payLocal areaFlexible hoursShift work- ...Neonatal Intensive Care Unit (NICU) Registered Nurse in Albuquerque, NM. Thrive in a People-... ...Excellence in Robotic Surgery by Surgical Review Corporation. Responsibilities The... ...care and staff management assigned to the RN in his/her charge. May serve in the role of...ReliefDay shift
$32 - $42 per hour
...Overview** **Dialysis Clinic, Inc.** is recruiting... ...Dialysis Home Therapies Nurse** coordinates the administrative... ...a plus + Current NM RN license + Valid... ...can be reviewed at: **Job Location**... ...US-NM-Albuquerque_ **Posted Date** _2 months ago_ _...Hourly payFull timeFor contractorsMonday to FridayShift work$1,808 per week
...Healthcare is seeking a travel nurse RN Dialysis for a travel nursing... ..., New Mexico? TRS Healthcare posted this Travel Nursing Job... ...Salary information and unbiased reviews from leading Travel Nurse... ..., trauma centers, standalone clinics, and more. Learn more about...Shift work$1,921 per week
...Health Advocates Network - Nursing is seeking a travel nurse RN Dialysis for a travel nursing job in Albuquerque... ...Health Advocates Network - Nursing posted this Travel Nursing Job that... ...Dialysis Salary information and unbiased reviews from leading Travel Nurse Agencies...Daily paidLong term contractTemporary workLocal areaFlexible hoursShift work
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