Average salary: $40,000 /yearly
More stats ...live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Clinical Review Pharmacist
The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests...
Suggested
Holiday work
Local area
Visa sponsorship
Work visa
Weekend work
...Description & Requirements
Maximus is hiring a Clinical Reviewer to support our North Dakota QRTP program. The Clinical Reviewer reviews Independent Contractor Assessor's findings and writes determination reports, creates individualized outcome reports, showing strengths...
Suggested
Permanent employment
Contract work
For contractors
Remote job
Home office
...the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene... ...of medical care.
+ Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness...
Suggested
Holiday work
Remote job
Flexible hours
...all Federal and State requirements.
+ Ensure second-level reviews have been performed and documented and may confer with medical... ...including d appeal and denial letters, NOMNC letters, AOR forms, clinical information.
+ Act as a point person for internal and...
Suggested
Hourly pay
Full time
Work experience placement
Remote job
Shift work
Weekend work
Monday to Friday
...We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Physician Clinical Reviewer, MRx – Oncology – REMOTE
Summary
Key member of the utilization management team, and provides timely medical review...
Suggested
Work experience placement
Internship
Local area
Remote job
...a part of the #1 full truckload carrier in the nation. Be a part of Swift Transportation.
Job Responsibilities: What you will do
Review violations, log and follow up to ensure compliance.
Are to include but are not limited to the following, other duties may be assigned...
Suggested
Local area
...Job Description
Role: Purchase Reviewer-1153
Estimated Duration: 6+ months
Location: Phoenix, AZ
Position Description
The purpose of this position is to provide support to constituents, including education administrators and staff, community members, education...
Suggested
Holiday work
Full time
Casual work
Local area
Shift work
Monday to Friday
...Job Description
Role: Purchase Reviewer (Resource)
Estimated Duration: 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
The purpose of this position is to provide support to constituents, including education administrators and staff, community...
Suggested
Local area
..., Retrospective UM. Supervises staff who conduct retrospective review of medical claims for appropriate DRG or non-DR coding and processing... ...(CCS) or Certified Professional Coder (CPC)
•2+ years of clinical experience
•2+ years coding experience
•2+ years...
Suggested
Remote job
Contract work
Temporary work
Local area
Shift work
...certificate required; associates degree preferred.
Two (2) years relevant credentialing experience preferred.
Two (2) years contract reviewing experience preferred.
Knowledge and understanding of the medical credentialing process, DEA certification, and CAQH and NHSC...
Suggested
Holiday work
Contract work
For contractors
Local area
...with less structured and more complex issues.
The Preservice Review/Prior Authorization RN will manage the full array of health... ...and Inpatient settings and with support from some specialized clinical teams, serves as a resource to others.
This new cross-functional...
Suggested
Remote job
Hourly pay
Minimum wage
Work experience placement
Local area
Weekend work
...owned community bank and one of Prairie Business Magazine's 50 best places to work for 10 years running. We are looking for a Credit Review Associate who can clearly identify borrower risk and translate the risk factors into terms others can understand within a narrative...
Suggested
Holiday work
Full time
...Are you looking for a non-clinical opportunity for work/life balance needs yet want to stay clinically active?
Join us as an Medical Director to conduct chart and peer reviews from your home office.
This is a Part Time 25 hours a week position...
Suggested
Remote job
Holiday work
Full time
Part time
Work from home
Home office
Weekend work
Monday to Friday
...Phoenix Medical Psychiatric Hospital is looking for a Utilization Review Coordinator to coordinate patients’ services across the... ...needed.
Initial Precertification with payors.
Concurrent Clinical review with payors.
Document in the electronic system daily...
Suggested
Full time
...Role: Penalty Review Specialist-1276
Estimated Duration: 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
Primary Duties:
Analyze applicant data for abatement consideration.
Request additional information when needed....
Suggested
Contract work
...Behavioral Health RN - Medical Claim Review - FULLY REMOTE POSITION
MUST HAVE ARIZONA OR COMPACT RN LICENSE
Medix Healthcare
Phoenix, AZ 85016
Monday-Friday 8am-5pm (Employee Time Zone)
$40.00-42.00 hour - FULL TIME
MUST HAVES TO APPLY
~ Arizona RN or...
Hourly pay
Full time
Contract work
Temporary work
Work experience placement
Remote job
Currently hiring
Monday to Friday
...FT 40 Hours Per Week
Shifts: Mid
As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing... ...the acute care medical hospital. This requires proficiency in clinical criteria, evidence-based practice, regulatory compliance,...
Hourly pay
Shift work
...passionate about cybersecurity and enhancing the security posture of clients product development lifecycle. You will apply your code review experience and contribute to a variety of services our team offers clients, particularly where we perform penetration testing...
Work experience placement
Local area
...Experienced Document Review Attorney – Remote
Great opportunity for l icensed attorneys with document review experience interested in quality focused e-Discovery. We have some projects anticipated to start soon and others in the pipeline. Please apply to get on...
Remote job
Hourly pay
Full time
Flexible hours
...Description For Value-Based Care (VBC) programs within HOPCo Clinically Integrated Networks (CINs), promotes adherence to evidence-based... ...experience is required
Orthopedic experience required.
Clinical review, utilization review, or quality assurance review experience...
Part time
...Custard Insurance Adjusters, Inc.
Property Claims Reviewer/QA
Phoenix, AZ
We are growing our company and looking for highly skilled team members to grow with us! We are looking for motivated individuals who are passionate about quality work and providing superior...
Full time
Remote job
Work from home
Flexible hours
Monday to Friday
...accessibility, integrity, and quality care are what is most important. We put a lot of emphasis on the thought that—in order for our clinical team to be accessible to clients—we must fully support our clinicians by allowing them to do what they are trained to do. We...
Part time
Private practice
...Job Description
Job Description
General Purpose
To review and bill Loss Control Inspections and ensure they meet Afirm/Davies quality control standards, customer specific requirements, and industry standards.
Essential Duties and Responsibilities:
~ Reviews...
For contractors
Remote job
...Become a part of our caring community and help us put health first
The Claims Review Representative 2 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative...
Weekly pay
Holiday work
Full time
Contract work
Temporary work
Apprenticeship
Remote job
Work from home
Home office
...abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive...
Full time
Remote job
Flexible hours
...statutes, rules, and compliance with policies and procedures.
The primary duties for this position include the following:
Review account expenses and complete account closures
Conduct audits on randomly selected accounts to assess program compliance...
Holiday work
Full time
Casual work
Local area
Immediate start
Shift work
Monday to Friday
...convenient patient care.
We are seeking a skilled and compassionate Clinical Supervisor to join our team in Phoenix, AZ. You will work... ....
Perform patient assessments, including medical history reviews and physical examinations.
Diagnose and treat acute and chronic...
...Responsibilities
Utilization Review (UR) Coordinator Opportunity.
Position: PRN (as needed)
This position is on-site and... ...an intensive outpatient program (IOP). We also have a satellite clinic offering Intensive Outpatient Programs in the West Valley region...
Relief
Local area
Remote job
...Opportunity
Therapy Tree is currently accepting applications for a Clinical Director to manage the daily operations and activities of a... ...Supervises the clinic staff, interviews and hires staff, and reviews staff performance
Identifies internal/external training...
Hourly pay
Holiday work
Local area
..., rewarding and recognizing our employees!
Overview:
As a Clinical Research Coordinator, youll oversee and facilitate the clinical... ...Submits documents to regulatory authorities (IRB, FDA, etc.) and/or review/monitoring boards
Facilitates study close out activities...
Holiday work
Flexible hours
Monday to Friday