A company is looking for a Clinical Review Nurse responsible for reviewing health claims and making medical determinations.
Key ResponsibilitiesReview and analyze pre and post-pay complex healthcare claims for medical necessity and appropriateness of careIdentify issues of concern in provider practices and recommend corrective actionsEducate providers on medical review processes through teaching activities and written materialsRequired QualificationsHigh School Diploma or GED2 years of clinical experienceValid unrestricted Registered Nurse (RN) licenseStrong computer skills, including proficiency in Microsoft OfficeExperience evaluating medical and healthcare delivery issues
Clinical Review Nurse
A company is looking for a Clinical Review Nurse. ...
RN Clinical Review Nurse
The Clinical Review Nurse is responsible for complying with the day-to-day operations of the Clinical Review Department. The Senior Director of Clinical Review will monitor the Clinical Review Nurse's activities and outcomes, ensuring compliance with established regulatory and contractual requiremen...
Clinical Review Nurse - LPN
A company is looking for a Clinical Review Nurse - Concurrent Review to perform concurrent reviews and evaluate member care. ...
Travel Nurse RN - Case Manager, Utilization Review - $3,252 per week
Medical Solutions is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Bronx, New York. Posted job title: Case Management (Utilization Review). ...
Travel Nurse - Registered Nurse - SDU - Stepdown Unit - $3627.29 / Week
Meda Health is seeking an experienced Stepdown Unit Registered Nurse for an exciting Travel Nursing job in Brooklyn, NY. ...
Travel Nurse - Registered Nurse - PP - Postpartum - $2359 / Week
Stability Healthcare is seeking an experienced Postpartum Registered Nurse for an exciting Travel Nursing job in New York, NY. If you are a registered nurse interested in Travel, Local Travel or Per Diem Nursing opportunities, Stability has the right assignment for you!. Stability HealthCare is a pr...
Outpatient Registered Nurse - RN
The professional registered nurse Outpatient RN CAP 1 is an entry level designation into the Clinical Advancement Program (CAP). Performs all essential functions under the direction of the Supervisor and with guidance from the Clinical Educator, Preceptor or in collaboration with other Registered Nu...
staff - Registered Nurse (RN) - Utilization Review - $85K-106K per year
VNS Health is seeking a Registered Nurse (RN) Utilization Review for a nursing job in Manhattan, New York. Posted job title: Rn Utilization Review. Develops forms, record abstracts, reports, and other tools used to implement concurrent and retrospective patient care review, including the design, tes...
Registered Nurse (RN) - Dialysis - $42-58 per hour
Davita Kidney Care is seeking a Registered Nurse (RN) Dialysis for a nursing job in Bronx, New York. Support for you and your family: family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave, pet insurance, and more. Certified Nephrology Nu...
Utilization Review RN - WV Licensed
A company is looking for a Utilization Review RN - Medicare to collaborate with the Medical Director and drive improvements in care management. ...