Nurse Reviewer jobs

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Clinical Care Reviewer, Concurrent Review, Registered Nurse
Preferred hospital medical necessity reviewer in-patient expertise. Refers cases to Medical Director for medical necessity review when medical information...
RN Nurse Care Manager I or II - Remote - Virginia 137261
Anthem, Inc. - 2,429 reviews - Richmond, VA
Partners with physician clinical reviewers and/or medical directors to interpret appropriateness of care, intervention planning, and general clinical guidance....

Clinical Reviewer - LPN/RN

Keystone Peer Review - Tampa, FL   +1 location
Clinical Reviewers - LPN/RN. BFCC Short Stay Clinical Nurse Reviewers will be responsible for conducting “Revised Determination Reviews” on a sample of...

Clinical Reviewer RN Colorado Springs

eviCore healthcare - 162 reviews - Colorado Springs, CO 80907 (Northeast Colorado Springs area)   +1 location
Want to know what a "day in the life" looks like for an eviCore Clinical Reviewer? Watch this video to learn more!...

CEVA Clin Reviewer (Nurse, Quality Controller)

QuintilesIMS - 932 reviews - United States
The CEVA Clinical Reviewer will provide assistance for less experienced CEVA Clinical Reviewers.  Review for relevance of source documents received after...

Nurse Reviewer

Banner Health - 1,052 reviews - Phoenix, AZ   +1 location
Requires Registered Nurse (R.N.). Works with authorized payors or reviewers to resolve denial management issues, reconsiderations and appeals....

Nurse Reviewer, Utilization

Mitchell International, Inc. - 3 reviews - Texas   +3 locations
Uses evidence-based, nationally recognized treatment protocols and accesses physician reviewers, as indicated, when certification/approval cannot be recommended...

UR Nurse Reviewer

HMS - 583 reviews - Charlestown, MA
Interacts with physician reviewers. Provides supporting reference documentation to the reviewer. The Nurse Reviewer is responsible for performing clinical...

Nurse Reviewer (Fraud & Abuse)

HMSA - 25 reviews - Honolulu, HI 96817 (Liliha-Kapalama area)
A Nurse Reviewer performs a detailed analysis and review of the medical records applying clinical expertise, evidence based clinical guidelines, HMSA policies...

Remote HEDIS Reviewer/Abstractor-RN/LPN Nurse

MedViewHealth - Cincinnati, OH
MedViewHealth is seeking RN’s and LPN’s for the 2018 HEDIS season. This is a contracted remote assignment running from January thru May 2018. *Must be...
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Clinical Care Manager/ Assessm

Aetna - 2,595 reviews - New York, NY 10016 (Gramercy area)
Nursing/ Registered Nurse (RN) is required. Assessment Nurse Reviewer is responsible for review of all initial assessments and development of Service Plans for...

Telephonic Inpatient Care Coordinator, RN

Kaiser Permanente - 5,803 reviews - Atlanta, GA
Attends scheduled weekly rounds with network physician reviewer to discuss clinical course, discharge planning and potential QA/UM concerns of all hospitalized...
Revenue Recovery RN
UCHealth - 341 reviews - Aurora, CO
State licensure as a Registered Nurse (RN). 1 year as a Utilization Reviewer, Case Manager or equivalent revenue cycle RN role....
Surgical Case Nurse Reviewer
Chenega Corporation - 306 reviews - Eglin Village, FL
The nurse reviewer performs chart abstraction and/or quality improvement projects for the NSQIP. The Surgical Case Nurse Reviewer (SCNR) shall provide...
Nurse Reviewer
Mercy - 258 reviews - Springfield, MO 65807
Registered Nurse or Licensed Practical Nurse and current RN/LPN license. Five or more years of clinical experience as a registered or licensed practical nurse....