Utilization review nurse jobs in Plano, TX
Utilization Review Nurse Remote/Local
We are looking for a Utilization Review Nurse Remote Local (Richardson, TX). The individual should be.. The UR Nurse determines medical necessity of these services by utilizing clinical expertise, judgment..
Remote Care Review Clinician, Inpatient Review BH - TX ONLY
Conducts inpatient reviews to determine financial responsibility for Molina Healthcare and its members.. May also perform prior authorization reviews and or related duties as needed. Processes requests within..
Utilization Management RN - Per Diem
What you will do. As a. Utilization Management Registered Nurse RN. you will conduct prospective, concurrent and retrospective reviews. Assist patients navigating the healthcare system. Ensure..
Utilization Management Nurse Consultant
Utilization Management Nurse ConsultantUtilizes clinical experience and skills in a collaborative.. years of experience as a Registered NurseMust have active current and unrestricted RN licensure in state..
Document Review Specialist (intake)
Medix Infusion is currently seeking a highly skilled and dedicated Document Review Specialist to join.. Review hard copy paperwork received for new and existing patients and streamline these to relevant team..
Loan Review Senior Consultant
Come grow with us! Job Description. Loan Review Senior Consultant Crowe is seeking a Loan Review Senior.. In this role, you will. Provide loan review services and other consulting engagements with clients on..
Telephonic Utilization Management Nurse (South Central Region)
Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively,. Humana ) offers competitive benefits that support whole person well being. Associate benefits ar..
Wholesale Credit Review - Vice President
Job Description The Credit Review team within the JPMC Internal Audit Department is responsible for.. The Credit Review team performs independent reviews of JPMC commercial loan portfolios that include an..
Director, Independent Assessment & Review
Join us to invest in yourself, your career, and the financial world. The role SoFi is seeking an energetic, analytic, and intellectually curious Independent Assessment & Review Manager to join..
Clinical Quality Review Spec
And Managing Individual Inventory Through Appropriate Workflow.Registered Nurse (RN) with unrestricted license in state of operations.5 years combine knowledge of healthcare processes.Knowledge..
Physician Review Coordinator
Under general supervision, assigns medical necessity requests to a qualified reviewer and follows up to.. and state licensure requirements.Upon receipt of completed determination, reviews for spelling and..
Clinical Quality Review Spec
TELECOMMUTE WORK. JOB REQUIREMENTS. Registered Nurse (RN) with unrestricted license in state of.. PREFERRED JOB REQUIREMENTS. Bachelor's degree. Utilization management experience. Health claims and..
Empower - Oasis Review Coding Specialist
Collaborate with interdisciplinary teams including nurses, therapists, and physicians to resolve.. Manage visit utilization by reviewing visit frequencies, durations, and documentation to ensure..
Healthcare Business Analyst - Expert Claims Review
Position Overview At Zelis, the Business Analyst. Expert Claims Review (ECR) is ultimately responsible.. This includes Itemized Bill Review, Clinical Chart Review, Dialysis Savings Solution and DRG Validation..
Communications Review Specialist
The Communications Review Specialist works under the direction of the Communications Review Manager and.. Communications Review SpecialistCareington is seeking a Communications Review Specialist to join its..
Sr. Manager - Commercial Credit Review
Manager. Commercial Credit ReviewCapital One is a diversified bank that offers a broad array of.. The Senior Manager will contribute towards the execution of the annual Credit Review operating plan and..
Bill Review Services Associate III
As a Bill Review Associate III, you will be responsible for reviewing and analyzing complex bills and.. The ideal candidate will have a strong background in bill review and possess excellent analytical and..
Wholesale Credit Review - Vice President
The Credit Review team within the JPMC Internal Audit Department is responsible for reviewing the credit.. The Credit Review Officer will lead members of the Credit Review team in activities that evaluate..