Talent.com
LA Licensed Clinical Review Nurse

LA Licensed Clinical Review Nurse

VirtualVocationsRaleigh, North Carolina, 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 • Raleigh, North Carolina, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Certified Medical Assistant - Perinatal

Certified Medical Assistant - Perinatal

Duke HealthDurham, North Carolina, United States
serp_jobs.job_card.full_time
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and disc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Clinical Review Nurse - Concurrent Review

Clinical Review Nurse - Concurrent Review

Spectraforce TechnologiesRaleigh, NC, United States
serp_jobs.job_card.full_time
Clinical Review Nurse - Concurrent Review.Monday through Friday, 9 : 30 AM to 6 : 00 PM CST.Performs concurrent reviews, including determining member's overall health, reviewing the type of care being ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Certified Medical Assistant- Dermatology

Certified Medical Assistant- Dermatology

Duke HealthChapel Hill, North Carolina, United States
serp_jobs.job_card.full_time
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and disc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Urgent Care APRN / PA-C - Zebulon NC (Immediate 10K Bonus)

Urgent Care APRN / PA-C - Zebulon NC (Immediate 10K Bonus)

JobotZebulon, NC, US
serp_jobs.job_card.full_time
Urgent Care NP / PA Provider role with 10K sign on bonus, Flex schedule, 401K Retirement and Generous benefits.This Jobot Job is hosted by : Donna Gawroski-Kusik. Are you a fit? Easy Apply now by cli...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Clinical Documentation Integrity Lead

Clinical Documentation Integrity Lead

VirtualVocationsDurham, North Carolina, 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
Certified Medical Assistant - Otolaryngology

Certified Medical Assistant - Otolaryngology

Duke HealthRaleigh, North Carolina, United States
serp_jobs.job_card.full_time
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and disc...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

VirtualVocationsRaleigh, North Carolina, 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
Urgent Care FNP / PA-C (Immediate 10K Sign on Bonus) Wilmington NC

Urgent Care FNP / PA-C (Immediate 10K Sign on Bonus) Wilmington NC

JobotCape Fear, NC, US
serp_jobs.job_card.full_time
Urgent Care NP / PA Provider role with $10,000 sign on bonus! Flex schedule, 401K Retirement and Generous benefits.This Jobot Job is hosted by : Donna Gawroski-Kusik. Are you a fit? Easy Apply now by...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

VirtualVocationsRaleigh, North Carolina, 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
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Clinical Lead III - Rare Disease

Clinical Lead III - Rare Disease

VirtualVocationsDurham, North Carolina, 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
Certified Coder Physician

Certified Coder Physician

VirtualVocationsDurham, North Carolina, 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
Senior Clinical Coordinator

Senior Clinical Coordinator

VirtualVocationsRaleigh, North Carolina, 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
Licensed RN Clinical Appeals Reviewer

Licensed RN Clinical Appeals Reviewer

VirtualVocationsRaleigh, North Carolina, 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 Response Specialist

Clinical Response Specialist

VirtualVocationsRaleigh, North Carolina, 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
Pennsylvania Licensed Clinical Appeals Reviewer

Pennsylvania Licensed Clinical Appeals Reviewer

VirtualVocationsRaleigh, North Carolina, 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
Certified Medical Assistant (CMA) - Durham Pediatrics

Certified Medical Assistant (CMA) - Durham Pediatrics

Duke HealthDurham, North Carolina, United States
serp_jobs.job_card.full_time
At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and disc...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
LA Licensed Clinical Review Nurse

LA Licensed Clinical Review Nurse

VirtualVocationsDurham, North Carolina, 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 determine overall health and appropriate level of care for members Review ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
South Carolina Licensed RN Reviewer

South Carolina Licensed RN Reviewer

VirtualVocationsDurham, North Carolina, 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

VirtualVocationsDurham, North Carolina, 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
  • serp_jobs.job_card.new
Arizona Licensed Clinical Coordinator

Arizona Licensed Clinical Coordinator

VirtualVocationsRaleigh, North Carolina, 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