Talent.com
Texas Licensed Clinical Review Nurse

Texas Licensed Clinical Review Nurse

VirtualVocationsSan Buenaventura, California, United States
job_description.job_card.30_days_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 assess member health and appropriate level of care

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

Collaborate with healthcare providers and Medical Affairs on care determinations and 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 in acute care required

Compact RN or LVN / LPN License required

Knowledge of Medicare and Medicaid regulations preferred

Familiarity with utilization management processes preferred

serp_jobs.job_alerts.create_a_job

Clinical Review Nurse • San Buenaventura, California, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Colorado Licensed Clinical Documentation Specialist RN

Colorado Licensed Clinical Documentation Specialist RN

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Documentation Specialist RN.Key Responsibilities Conducts concurrent reviews of clinical documentation in medical records to ensure compliance and accuracy for...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Maryland Licensed Clinical Appeals RN

Maryland Licensed Clinical Appeals RN

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals RN to work on post-service appeals for Medicare-based claims remotely.Key Responsibilities : Review provider post-service appeals for Medicare and Retir...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
California Licensed Quality Improvement Nurse

California Licensed Quality Improvement Nurse

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Quality Improvement Nurse PQI (RN).Key Responsibilities Develops and manages healthcare strategies in alignment with DHCS standards to improve member health outcomes E...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Florida Licensed Clinical Therapist

Florida Licensed Clinical Therapist

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Licensed Clinical Therapist (LCSW / LMHC / LMFT) for an Adult Intensive Outpatient Virtual Group. Key Responsibilities Provide virtual IOP remote group coverage via video co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
California Licensed Nurse Practitioner

California Licensed Nurse Practitioner

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Nurse Practitioner.Key Responsibilities : Review member's medical history and conduct telehealth consultations Generate medical orders and prepare reports on imaging st...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
California Licensed Clinical Appeals RN

California Licensed Clinical Appeals RN

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Appeals RN, fully remote, requiring 4 or 5 workdays per week with weekends required.Key Responsibilities Review medical records and verify if requested service...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Texas Licensed Clinical Review Nurse

Texas Licensed Clinical Review Nurse

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Perform concurrent reviews to assess member health and appropriate level of care Review quality and cont...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Ohio Licensed Ambulatory Care RN

Ohio Licensed Ambulatory Care RN

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Registered Nurse Ambulatory Care Manager (RN) - Population Health.Key Responsibilities Provide clinical care management services to eligible patients, coordinating care...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Missouri Licensed Nurse Case Manager

Missouri Licensed Nurse Case Manager

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Nurse Case Manager II.Key Responsibilities Utilizes a collaborative process for assessment, planning, facilitation, and advocacy to meet individual health needs Conduc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Connecticut Licensed LPN Chart Reviewer

Connecticut Licensed LPN Chart Reviewer

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Licensed Practical Nurse (LPN) Chart Reviewer for a long-term project.Key Responsibilities Audit patient files electronically to abstract pertinent data and identify ga...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Florida Licensed Utilization Management RN

Florida Licensed Utilization Management RN

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Management RN PRN.Key Responsibilities Analyze patient records to assess hospital admissions, treatment legitimacy, and appropriate care levels Facilitate ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
New York Licensed Clinical Review Nurse

New York Licensed Clinical Review Nurse

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Prior Authorization.Key Responsibilities Analyze prior authorization requests to determine medical necessity and appropriate level of care Coor...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Bilingual RN - Multi-State Licensed

Bilingual RN - Multi-State Licensed

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Bilingual Registered Nurse (RN) to work from home.Key Responsibilities Provide telehealth and virtual care clinical triage assessments and health education to patients ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Georgia Licensed Utilization Management RN

Georgia Licensed Utilization Management RN

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for an RN Central Utilization Management.Key Responsibilities Conduct medical necessity reviews and clinical assessments for patient admissions and ongoing care Ensure timel...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
State Licensed Oncology Nurse Reviewer

State Licensed Oncology Nurse Reviewer

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a UM Nurse Reviewer - Oncology.Key Responsibilities Apply oncology clinical expertise to ensure outputs align with payer requirements and evidence-based guidelines Monit...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
California Licensed Nurse RN

California Licensed Nurse RN

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Nurse RN 3 to review medical necessity for various levels of care.Key Responsibilities Evaluate medical necessity across different care levels using clinical expertise ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
North Carolina Licensed Clinical Nurse

North Carolina Licensed Clinical Nurse

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for an RN Clinical Nurse II - Nurse Connect.Key Responsibilities Provide clinical nursing care and coordinate patient care utilizing the nursing process Participate in patie...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Utah Licensed Clinical Triage Nurse

Utah Licensed Clinical Triage Nurse

VirtualVocationsSan Buenaventura, California, United States
serp_jobs.job_card.full_time
A company is looking for a Labor & Delivery, Clinical Triage Nurse, Work From Home.Key Responsibilities Provide clinical triage for labor and delivery patients Assess patient needs and coordinat...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
California Licensed Nurse Reviewer

California Licensed Nurse Reviewer

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Nurse Itemized Bill Reviewer (IBR Analyst).Key Responsibilities Perform in-depth reviews of medical claims using UB-04 and itemized statements Verify accuracy of itemi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Missouri Licensed Case Manager RN

Missouri Licensed Case Manager RN

VirtualVocationsOxnard, California, United States
serp_jobs.job_card.full_time
A company is looking for a Case Manager, Registered Nurse (Remote).Key Responsibilities Engage with members telephonically to coordinate their care and develop individualized care plans Provide ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days