Delaware Licensed Clinical Review NurseVirtualVocations • Springfield, Missouri, United States
Delaware Licensed Clinical Review Nurse
VirtualVocations • Springfield, Missouri, United States
job_description.job_card.variable_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 - Prior Authorization.
Key Responsibilities
Analyzes prior authorization requests to determine medical necessity and appropriate level of care
Provides recommendations to medical teams to promote quality and cost-effective care
Documents and maintains members' clinical information in health management systems for compliance
Required Qualifications
Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing
2-4 years of related experience preferred
Licensed Practical Nurse (LPN) - State Licensure required
RN license required for specific locations
serp_jobs.job_alerts.create_a_job
Clinical Review Nurse • Springfield, Missouri, United States
Job_description.internal_linking.related_jobs A company is looking for a Clinical Audit Lead.Key Responsibilities Supervises teams to ensure compliance with laws, regulations, and organizational policies Implements measures to mitigate risk...serp_jobs.internal_linking.show_more 
TravelNurseSource is working with Ventura MedStaff to find a qualified ICU / Critical Care RN in Springfield, Missouri, 65804!.
Are you ready to take your Travel career to the next level? See places ...serp_jobs.internal_linking.show_more A company is looking for a Michigan Utilization Review Nurse - LPN (100% Remote).Key Responsibilities Perform Utilization Review to determine the medical necessity of services for Michigan Auto N...serp_jobs.internal_linking.show_more A company is looking for a Utilization Review Nurse.Key Responsibilities Perform prospective, concurrent, and retrospective utilization reviews using evidence-based guidelines Evaluate severity ...serp_jobs.internal_linking.show_more A company is looking for a Manager of Prior Authorization UM - Aetna Medicaid Texas - RN.Key Responsibilities Lead and manage the prior authorization team, including hiring, training, and perform...serp_jobs.internal_linking.show_more A company is looking for a Clinical Review Nurse - Prior Authorization.Key Responsibilities Review both prior authorization (PA) and inpatient (IP) requests Complete up to 20 authorization revie...serp_jobs.internal_linking.show_more A company is looking for a DRG Clinical Validation Nurse.Key Responsibilities : Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical reco...serp_jobs.internal_linking.show_more A company is looking for a Clinical Reviewer to perform Utilization Management and review clinical information for service requests.
Key Responsibilities Evaluate referral appropriateness for serv...serp_jobs.internal_linking.show_more A company is looking for a Clinical Quality LPN for a short-term contract position.Key Responsibilities Perform administrative tasks related to Adverse Event referrals and case management Assist...serp_jobs.internal_linking.show_more A company is looking for an Out of Network (OON) Clinical Case Manager (CM) - Remote (CA Only) - Per diem - Variable.Key Responsibilities Coordinate quality healthcare services in out of network ...serp_jobs.internal_linking.show_more A company is looking for a Registered Nurse - Clinical Case Consultant (CalAIM ECM Program).Key Responsibilities Provide clinical oversight and guidance to care coordinators and case managers, en...serp_jobs.internal_linking.show_more A company is looking for an RN Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine overall health and appropriate level of care for members Re...serp_jobs.internal_linking.show_more Key Responsibilities Conduct MS-DRG and APR-DRG coding reviews to verify accuracy and identify overpayments Perform clinical coding reviews ensuring accuracy and compliance with coding guideline...serp_jobs.internal_linking.show_more 
Premier Medical Staffing Services is seeking a travel nurse RN Rehabilitation for a travel nursing job in Buffalo, Missouri.
Job Description & Requirements.New Grads OKAY- as long as a Level II ...serp_jobs.internal_linking.show_more A company is looking for a Clinical Quality Nurse Reviewer, Sr.Key Responsibilities Perform QA checks on complex clinical claim reviews Review and analyze claim data and medical records using ap...serp_jobs.internal_linking.show_more A company is looking for a Director, Clinical Excellence (Post Acute, VBC).Key Responsibilities Lead the operational delivery of the post-acute care program to ensure coordinated patient transiti...serp_jobs.internal_linking.show_more A company is looking for a Behavioral Health Utilization Management Reviewer.Key Responsibilities Conduct medical necessity reviews for inpatient and outpatient services Collaborate with members...serp_jobs.internal_linking.show_more A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine overall health and appropriate level of care for members Review...serp_jobs.internal_linking.show_more
State Licensed Clinical Audit Lead
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Travel Nurse RN - Intensive Care Unit (ICU) / Critical Care - $1,784 to $1,984 per week in Springfield, MO
TravelNurseSource • Springfield, MO, US
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Michigan Licensed Utilization Review Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Licensed Utilization Review Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Texas Licensed RN Manager
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Oregon Licensed Clinical Review Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
New York Licensed Clinical Validation Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_1_hour • serp_jobs.job_card.promoted • serp_jobs.job_card.new
State Licensed Clinical Reviewer
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Hawaii Licensed Clinical Quality LPN
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.temporary
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
California Licensed Clinical Case Manager
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
California Licensed Clinical Case Consultant
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
New York RN Clinical Review Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Remote Clinical Claim Review RN
VirtualVocations • Springfield, Missouri, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Travel Nurse RN - Rehabilitation
Premier Medical Staffing Services • Buffalo, MO, US
serp_jobs.job_card.permanent
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Texas Licensed Clinical Quality Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
State Licensed Director of Clinical Excellence
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Licensed Behavioral Health Reviewer
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Arizona Licensed Clinical Review Nurse
VirtualVocations • Springfield, Missouri, United States
serp_jobs.job_card.full_time
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted