RN Clinical Reviewer jobs

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CLINICAL REVIEWER (SURGICAL OR BARIATRIC)-Quality Enhancemen...
HonorHealth - 106 reviews - Scottsdale, AZ
Clinical chart review and abstraction experience required. 1 year hospital surgery, surgical clinic, clinical research, or medical records experience....
Sponsored
Registered Nurse (RN) Clinical Reviewer
Menorah Medical Center - 25 reviews - Overland Park, KS
The RN Clinical Reviewer supports regulatory compliance with JCAHO standards. Registered Nurse (RN) Clinical Reviewer....
Sponsored by HCA Inc
Nurse Reviewer
Mercy - 135 reviews - Springfield, MO
Maintain strict confidentiality of clinical information. Five or more years of clinical experience as a registered nurse....
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Clinical Reviewer

Fidelis Care - 111 reviews - New York, NY
Clinical Experience required. The Clinical Reviewer performs medical record reviews to determine the quality of care;...

RN Clinical Reviewer

Myers and Stauffer LC - 4 reviews - Baltimore, MD  +2 locations
Current RN license in good standing. The RN Clinical Reviewer will independently review/audit medical records associated with claims and work in a team...

SPECIALTY DRUG UM NURSE

Healthsmart Preferred Care - Charleston, WV
• Research clinical questions from employers, members and payors as required. • Perform case referral to Case Management and to Physician Reviewer....

RN Medical Reviewer II

BlueCross BlueShield of South Carolina - 3,277 reviews - Columbia, SC
Two years of clinical experience. Active RN licensure in state hired, OR active compact multi-state RN license as defined by the Nurse Licensure Compact (NLC)....

Clinical Quality Nurse Reviewer

Magellan Health - 38 reviews - Albuquerque, NM 87113 (Alameda N Valley area)
Will substitute 5 or more years of clinical experience along with an Associate’s degree and RN licensure.Experience:....

Nurse Medical Mgmt l - Medicaid - Louisville, KY (118462)

Anthem, Inc. - 1,554 reviews - Louisville, KY
Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management...

Nurse Reviewer

HMS - 460 reviews - Charlestown, MA
Unrestricted RN license. Interacts with physician reviewers. Provides supporting reference documentation to the reviewer....

Review Nurse-PA/UM - Part Time

Georgia Medical Care Foundation, Inc. - Atlanta, GA
Evaluate clinical information; • RN with current Georgia license required • Three to five years of recent clinical experience in at least one of the following;...

Nurse Reviewer

Mercy - 135 reviews - Springfield, MO
Maintain strict confidentiality of clinical information. Five or more years of clinical experience as a registered nurse....

Nurse Medical Management I - Charleston, WV - 118235

Anthem, Inc. - 1,554 reviews - Charleston, WV
Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management...
Medical Review Clinician
Must have applicable RN certification/license. Coordination of documentation sent to reviewers. Writing clinical summaries and review/edit returned reviews....
Sponsored
Call Center Nurse - Virginia Beach, VA - 118704
May access and consult with peer clinical reviewers, Medical Directors and/or delegated clinical reviewers to help ensure medically appropriate, quality, cost...
Sponsored

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