Talent.com
Tennessee Licensed Senior Medical Reviewer

Tennessee Licensed Senior Medical Reviewer

VirtualVocationsDavie, Florida, United States
job_description.job_card.1_day_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 Registered Nurse Senior Medical Reviewer (Medicare Part B).

Key Responsibilities

Lead and provide guidance to staff in specialty programs, medical review, and utilization management

Monitor workflow and assist in managing workloads and quality reviews

Ensure compliance with quality plans and participate in special projects as needed

Required Qualifications, Training, and Education

Active, unrestricted RN licensure in the United States or a compact multistate license

Associate Degree in Nursing or graduation from an accredited school of nursing

Four years of clinical experience or a combination of clinical and medical review experience totaling four years

Working knowledge of managed care and healthcare delivery systems

Proficiency in Microsoft Office software

serp_jobs.job_alerts.create_a_job

Medical Reviewer • Davie, Florida, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Texas Licensed Clinical Abstract RN

Texas Licensed Clinical Abstract RN

VirtualVocationsFort Lauderdale, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Other - Abstract RN.Key Responsibilities Conduct electronic medical record abstraction services accurately and efficiently Abstract information from electroni...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Medical Review Contractor

Medical Review Contractor

VirtualVocationsMiami, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Review Contractor to serve as a liaison to cross-functional teams and incorporate current medical information into departmental resources.Key Responsibilities P...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Florida Licensed Clinical Review Nurse

Florida Licensed Clinical Review Nurse

VirtualVocationsFort Lauderdale, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine members' overall health and appropriate level of care Reviews q...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Oregon Licensed Clinical Peer Review RN

Oregon Licensed Clinical Peer Review RN

VirtualVocationsBoca Raton, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Peer Review RN Coordinator (Performance Improvement).Key Responsibilities Coordinate and manage peer review processes with precision and discretion Serve as a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Florida Licensed Medical Adjuster

Florida Licensed Medical Adjuster

VirtualVocationsMiami, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Worker's Comp Medical Only Adjuster.Key Responsibilities Conduct initial investigations of assigned medical-only claims and contact relevant parties within 48 hours Re...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Virginia Licensed Lead Clinical Reviewer

Virginia Licensed Lead Clinical Reviewer

VirtualVocationsBoca Raton, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Lead Clinical Reviewer to join their team.Key Responsibilities Review medical records against criteria to determine medical appropriateness Guide team members and supp...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Medical Bill Reviewer

Medical Bill Reviewer

VirtualVocationsMiami, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Bill Reviewer-100% remote (EST or CST time zone).Key Responsibilities Identify provider participation status when automated processes fail Apply PPO guidelines...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Florida Licensed Preservice Review Nurse

Florida Licensed Preservice Review Nurse

VirtualVocationsHialeah, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Preservice Review Nurse RN - Remote.Key Responsibilities Perform clinical coverage review services, interpreting state and federal mandates and clinical information Co...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Tennessee Licensed Senior Medical Reviewer

Tennessee Licensed Senior Medical Reviewer

VirtualVocationsPompano Beach, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Registered Nurse Senior Medical Reviewer (Medicare Part B).Key Responsibilities Lead and provide guidance to staff in specialty programs, medical review, and utilizatio...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Tennessee and Missouri RN Clinical Review Coordinator

Tennessee and Missouri RN Clinical Review Coordinator

VirtualVocationsMiami, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a LOS Clinical Review Coordinator for TN and MO.Key Responsibilities Request and review member's clinical information from providers Perform utilization review of inpati...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 Utilization Review Lead

Missouri Licensed Utilization Review Lead

VirtualVocationsDavie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Utilization Review Coordinator, Lead.Key Responsibilities Serve as a liaison among physician, nursing staff, and ancillary departments to facilitate patient processing ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Remote Medical Coding Reviewer

Remote Medical Coding Reviewer

VirtualVocationsMiami, Florida, United States
serp_jobs.filters.remote
serp_jobs.job_card.full_time
A company is looking for a Medical Coding Reviewer I.Key Responsibilities Perform clinical / coding medical claim review to ensure compliance with coding practices Analyze provider billing practic...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Medical Reviewer

Medical Reviewer

VirtualVocationsDavie, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Reviewer.Key Responsibilities Lead statistical programming activities for clinical safety data sets Oversee the creation and validation of SDTM, ADaM, and TLFs...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
North Carolina Licensed Case Manager

North Carolina Licensed Case Manager

VirtualVocationsBoca Raton, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Remote Case Manager (RN).Key Responsibilities Collaborate with a health care team to monitor utilization patterns and facilitate appropriate health care delivery Condu...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
South Carolina Licensed Senior Medical Director

South Carolina Licensed Senior Medical Director

VirtualVocationsTamarac, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Medical Director to oversee medical review strategies and collaborate with stakeholders. Key Responsibilities Oversee the development and implementation of Medica...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Orthopedic Surgery- Independent Medical Examiner (IME)- Fort Lauderdale

Orthopedic Surgery- Independent Medical Examiner (IME)- Fort Lauderdale

Dane Street, LLCFort Lauderdale, FL, US
serp_jobs.job_card.full_time
Dane Street is expanding our physician panel! This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Travel L&D RN

Travel L&D RN

Nightingale NursesFort Lauderdale, FL, US
serp_jobs.job_card.full_time
Nightingale Nurses is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Fort Lauderdale, Florida.Job Description & Requirements. You may not realize it, but as an RN with ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Licensed Physical Therapy Reviewer

Licensed Physical Therapy Reviewer

VirtualVocationsMiami, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Reviewer, Physical Therapy.Key Responsibilities Evaluate cases that do not pass the authorization approval process and promote a supportive team approach Revi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Medical Reviewer III

Medical Reviewer III

VirtualVocationsTamarac, Florida, United States
serp_jobs.job_card.part_time
A company is looking for a Medical Reviewer III for a remote position.Key Responsibilities Provide medical review consultancy to support US Immunology Medical Affairs teams Ensure compliance wit...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Medical Director - Tyler, Texas Metro Area

Medical Director - Tyler, Texas Metro Area

GpacMiami, Florida, United States
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
Metropolitan Area of Tyler, Texas.It boasts an impressive six-figure salary plus production, significant relocation assistance, and a fantastic equity bonus package valued at $400K for each Veterin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30