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Medical review nurse jobs

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Pre-Service Medical Review Nurse - RN

Integrated Resources, Inc

 ...Job title: Pre-Service Medical Review Nurse - RN Location: Remote Duration: 3 months (potential for FTE) Previous CMS experience and review of all organization determinations, including pharmacy reviews. • Top candidates are those that have Jiva, Seibel, and... 
Jacksonville, FL
3 days ago

Medical Case Reviewer-LPN

The CSI Companies

 ...has partnered with a leading healthcare organization looking to add a Medical Case Reviewer-LPN to their team in Clearwater, FL.  Responsibilities:  Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient and outpatient... 
Clearwater, FL
3 days ago

Utilization Review Nurse

Memorial Health

Overview Performs clinical review of patient records to evaluate the utilization of acute...  ...to third party payors to support the medical necessity of the hospital admission for services...  ...Education: Associates Degree in Nursing. Bachelor's Degree in Nursing preferred.... 
Springfield, IL
1 day ago

Medical Records Reviewer

Medical Professionals

 ...We are seeking a detail-oriented, and knowledgeable medical records candidate to manage complex medical files. As a Medical Records Reviewer, you will be responsible for organizing, scanning, indexing claims records electronically. This important position provides... 
Philadelphia, PA
9 days ago

Medical Review Verification Specialist

Express Employment Professionals

 ...A well established and growing durable medical equipment company is seeking a full-time experienced Medical Review Verification Specialist. Looking for a positive person who is interested in being a success. Company calls for superior customer service, and a commitment... 
Rome, NY
3 days ago

HEDIS Medical Record Reviewer

Spectraforce Technologies Inc

 ...Title: HEDIS Medical Record Reviewer Work Location: Telecommute Duration: 4 months Day to Day Responsibilities of this Position and Description of Project: This position will be in support of the HEDIS Medical Record Review (MRR) cycle. The individuals... 
Atlanta, GA
9 days ago

Utilization Management Review Nurse

Memorial Health

Overview Performs clinical review of patient records to evaluate the utilization of acute...  ...to third party payors to support the medical necessity of the hospital admission for services...  ...Education: Associates Degree in Nursing. Bachelor's Degree in Nursing preferred.... 
Springfield, IL
1 day ago

Registered Nurse - Utilization Review

Ascension

 ...We Are Hiring Registered Nurse - Utilization Review - Case Management 001 - Part-Time, Day - Chevy Chase Building - Austin,TX Schedule...  ...teaching hospitals which serve as training sites for Dell Medical School at The University of Texas. Ascension is a faith... 
Austin, TX
1 day ago

Utilization Review Nurse

Physicians Health Plan of Northern Indiana, Inc.

 ...policies, performs initial utilization reviews, including pre-admission certifications,...  ...appropriate member use of benefits at the medically necessary level of care for the member’s...  ...required: NOTE: Utilization Review Nurses do not issue clinical denials. They perform... 
Fort Wayne, IN
2 days ago

Utilization Review Nurse

Healthcare Support

 ...Are you an experienced Utilization Review Nurse looking a new opportunity with a prestigious healthcare company? Do you want the chance...  ...Responsibilities: ~ This candidate will be reviewing medical records for medical necessity and ensuring members are receiving... 
Linthicum Heights, MD
9 days ago

Quality Review Nurse

The CORE Institute

 ...CORE Institute continues to grow, we are looking for a  Quality Review Nurse in our Quality Department. Please see below for the...  ...Through Evidence program. Utilizes extensive knowledge of medical terminology and coding to analyze quality patient care. Completes... 
Phoenix, AZ
9 days ago

Utilization Review Nurse

Ensign Services

 ...Utilization Review Nurse Licensure: Washington Registered Nurse License *This role will be a hybrid of social work, admissions, and...  ...matching contributions, career advancement opportunities, and medical, dental, and health insurance.  Take a look at these benefits... 
Bainbridge Island, WA
9 days ago
new

3rd Party Medical Reviewer - Part Time

Mitchell

 ...restoring lives. Job Description The Medical Claims Consultant utilizes his/her clinical skill set to review medical records and bills, specifically comprehension...  ..., orthopedic, physical and rehabilitation nursing is required. Experience: Mitchell’s Medical... 
San Diego, CA
13 hours ago

Medical Reviewer

MMS Holdings Inc.

 ...Life Sciences Awards. For more information, visit or follow MMS on LinkedIn. We're looking for an experienced Clinical/ Medical Reviewer who will report into our Director of Drug Safety and Pharmacovigilance. This role is fulltime for at least one year, with extension... 
Charleston, SC
1 day ago

Utilization Review Nurse RN

A-Line Staffing Solutions

 ...Full time Utilization Review Nurse RN openings in the  Corpus Christi, TX 78401 area with a major healthcare company! Starting ASAP!!...  ...management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select... 
Corpus Christi, TX
1 day ago

Medical Review Nurse (Hospice Review)

Integrity Management Services, Inc.

 ...focus on advancing their professional development and careers. Large company perks. Small company feel. [ We are seeking a Medical Review Nurse (RN) with medical review experience to join our team. The position requires the individual to conduct medical record reviews... 
Alexandria, VA
23 hours ago

Registered Nurse Review Analyst

Strategic Staffing Solutions

 ...RN Review Analyst - Remote Role Summary: Responsible for the approval...  ...Requirements: Registered Nurse with current Michigan driver's license....  ...experience preferred. Expertise in the use of medical terminology. Job Requirements:... 
Detroit, MI
3 days ago

Registered Nurse - Utilization Review

A-Line Staffing Solutions

 ...Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as...  ...Case Manager, Care Manager, Utilization Review, Utilization Management, STARS, HEDIS, Complex...  ...Medicaid, HMO, RN, BSN, MSN, Registered Nurse, Quality Assurance, Quality Improvement... 
Corpus Christi, TX
3 days ago

Registered Nurse - HEDIS Review

A-Line Staffing Solutions

 ...(Starting Remote) whom are in need of an experienced HEDIS Review Registered Nurse to become a part of the team, for an remote/work from home...  ...standards and/or custom or other measure set standards ~ Review medical records and abstract data for HEDIS and other measure sets... 
Austin, TX
3 days ago

Registered Nurse/Medical Review

ORM Fertility

 ...cutting-edge Embryologists and a team of very talented clinicians and administrators seeking a contracted Registered Nurse to complete 5 medical reviews per week for gestational surrogacy candidates. Description The Gestational Surrogacy Medical Review RN utilizes... 
Portland, OR
a month ago