Talent.com
LA Licensed Clinical Review Nurse

LA Licensed Clinical Review Nurse

VirtualVocationsNewark, Delaware, United States
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Clinical Review Nurse - Concurrent Review.

Key Responsibilities

Perform concurrent reviews to determine overall health and appropriate level of care for members

Review quality and continuity of care, including acuity level and discharge planning

Collaborate with healthcare providers and Medical Affairs to discuss member care and provide recommendations

Required Qualifications, Training, and Education

Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing

2 - 4 years of related experience, with 2+ years of acute care experience required

Knowledge of Medicare and Medicaid regulations preferred

Knowledge of utilization management processes preferred

LPN - Licensed Practical Nurse - State Licensure required

serp_jobs.job_alerts.create_a_job

Clinical Review Nurse • Newark, Delaware, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Nurse Practitioner (Psychiatric )

Nurse Practitioner (Psychiatric )

LifeStance HealthWest Chester, PA, US
serp_jobs.job_card.full_time
At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better. Our mission is to help people lead healthier, more fulfilling lives...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
South Carolina Licensed RN Reviewer

South Carolina Licensed RN Reviewer

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for an RN Medical Reviewer II to perform medical reviews and support medical claims processing.Key Responsibilities Conduct medical claim reviews for complex services and det...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
RN Clinical Appeals Reviewer

RN Clinical Appeals Reviewer

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for an IBR Clinical Appeals Reviewer - Remote.Key Responsibilities Analyze and respond to IBR Appeals inquiries Perform medical record reviews and prepare written appeals C...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
ObGyn Hospitalist

ObGyn Hospitalist

RecruitWellWest Chester, Pennsylvania, US
serp_jobs.job_card.full_time
ObGyn Hospitalist physician job in Pennsylvania : .Locum Tenens OB / GYN HospitalistLocation : West Chester, PennsylvaniaProgram Start Date : July 2019Position Type : Locum Tenens 24-Hour Shifts.Shift ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Senior Clinical Operations Lead

Senior Clinical Operations Lead

Incyte CorporationWilmington, DE, United States
serp_jobs.job_card.full_time
Incyte is a biopharmaceutical company focused on the discovery, development, and commercialization of novel medicines to meet serious unmet medical needs in oncology and inflammation and autoimmuni...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
California Licensed Review Nurse

California Licensed Review Nurse

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Pre-Service Review Nurse RN to work remotely in the Pacific or Mountain Time Zones.Key Responsibilities Conduct utilization management, including Prior Authorization Re...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Clinical Lead III - Rare Disease

Clinical Lead III - Rare Disease

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Lead III (Rare Disease) to join their Global Clinical Management team.Key Responsibilities Lead global clinical teams and enhance efficiencies across studies a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Clinical Response Specialist

Clinical Response Specialist

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Response Specialist - PRN.Key Responsibilities Assist patients, families, and providers in navigating the admissions process Complete intake calls and manage ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Certified Coder Physician

Certified Coder Physician

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Coder Physician.Key Responsibilities Abstract, code, sequence, and interpret clinical information from various medical records Assign correct principal and secondary d...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Arizona Licensed Clinical Coordinator

Arizona Licensed Clinical Coordinator

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Administrative Coordinator.Key Responsibilities Process all release of information (ROI) requests, ensuring compliance with regulations and client policies Pr...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Certified Medical Assistant

Certified Medical Assistant

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Certified Medical Assistant to work remotely at a rate of $17 / hour starting on 11 / 13 / 25. Key Responsibilities Receive and respond to prescription refill requests through...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Licensed RN Clinical Appeals Reviewer

Licensed RN Clinical Appeals Reviewer

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for an IBR Clinical Appeals Reviewer who will analyze and respond to client and hospital claim review appeal inquiries. Key Responsibilities : Analyze scope and resolution of I...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Clinical Documentation Integrity Lead

Clinical Documentation Integrity Lead

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Documentation Integrity Lead - Service Line (Remote).Key Responsibilities Manage relationships between CDI and assigned service lines, collaborating with physi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Hospitalist

Hospitalist

CompHealthSalem, New Jersey, US
serp_jobs.job_card.full_time
Hospitalist physician job in New Jersey : Come practice in Salem, NJ.Salem is located along the Salem River, with access to water and upgraded railways to support current and future industrial grow...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Senior Clinical Coordinator

Senior Clinical Coordinator

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Clinical Administrative Coordinator.Key Responsibilities Act as a Subject Matter Expert for team members Manage the intake of members with benefit reviews and i...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Pennsylvania Licensed Clinical Appeals Reviewer

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals Reviewer.Key Responsibilities Process appeals while ensuring compliance with regulatory milestones Review medical records for documentation and billin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Patient Financial Navigator

Patient Financial Navigator

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Patient Financial Navigator I.Key Responsibilities Ensure accurate patient medical records, including demographics and insurance coverage Provide financial education t...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
State Licensed Utilization Review Nurse

State Licensed Utilization Review Nurse

VirtualVocationsNewark, Delaware, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Review Nurse (PRN).Key Responsibilities Review and evaluate electronic medical records for emergency admissions to assess medical necessity Apply clinical ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30