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Clinical Auditor (LVN or RN OASIS Reviewer)
Pathways Home Health And Hospice - Sunnyvale, CA 94085
We currently have an excellent opportunity for an OASIS Reviewer – Home Health. The Quality Reviewer in Home Health supports the organization’s mission to...
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Nurse Reviewer (Recent RN Grads and Experienced RNs) - AIM S...
Anthem, Inc. - 2,809 reviews - Glendale, CA 91205
Nurse Reviewer I specific qualifications:. Develops telephone service standards to meet departmental performance metrics Nurse Reviewer I & Nurse Reviewer...
Registered Nurse - Surgical Clinical Reviewer
Registered Nurse (RN) - Surgical Clinical Reviewer (SCR). Travis AFB, CA....
Appeals RN
Northwell Health - 725 reviews - Melville, NY 11747
Current license to practice as a Registered Professional Nurse in New York State. Serves as a resource to all hospital staff on managed care and third party...

Utilization Management Clinical Auditor

MetroPlus Health Plan - 92 reviews - New York, NY
$110,411 a year
Registered Nurse with current New York State Nursing license. Conducts quality audit program to ensure case reviews are performed accurately and consistently by...

Mgr I Medical Management

Anthem, Inc. - 2,809 reviews - Westchester, IL
AIM is currently seeking a registered nurse to be Manager I Medical Management within the Clinical Operations team....

Medicaid Quality Review Nurse

Qlarant - Washington, DC
The Medical Quality Review Nurse independently performs clinical assessment functions of the review program as outlined by procedures, by conducting an initial...
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RN Nurse Case Mgr I (Special Programs) Remote

Anthem, Inc. - 2,809 reviews - California
Special Programs Nurse Case Manager - must live in California in any of the following locations:. The Nurse Case Manager is responsible for collaborating with...

Appeals RN

Northwell Health - 725 reviews - Melville, NY 11747
Current license to practice as a Registered Professional Nurse in New York State. Serves as a resource to all hospital staff on managed care and third party...

RN Bill Review Manager

PROFESSIONAL SEARCH - Torrance, CA
$120,000 - $130,000 a year
Must hold a current Experienced Medical Bill Reviewer Designation as a result of meeting the requirement for Workers’ Compensation medical bill reviewing...
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Outside Care Clinic Reviewer RN

Kaiser Permanente - 6,851 reviews - Pasadena, CA
Responsible for ensuring that Kaiser Permanente reimburses outside providers only for services that are authorized by physicians and that charges are...

RN Bariatric Clinical Reviewer

Palomar Health - 44 reviews - Poway, CA 92064
Understands and adheres to the California Nurse Practice Act, The American Nurses Association (ANA) Code of Ethics for Nurses, the ANA Bill of Rights for...

Regulatory Affairs Associate 2-Salt Lake City

PRA Health Sciences - 216 reviews - Salt Lake City, UT
Registered nurse) required. Perform role of Local Reviewer in the QC process as appropriate. Regulatory Affairs Associate 2-Salt Lake City....

Clinical Auditor (LVN or RN OASIS Reviewer)

Pathways Home Health And Hospice - Sunnyvale, CA 94085
We currently have an excellent opportunity for an OASIS Reviewer – Home Health. The Quality Reviewer in Home Health supports the organization’s mission to...
Easily apply
Medical Director - Remote
Fidelis Care - 231 reviews - Rego Park, NY 11374
Evaluates authorization requests in a timely manner and provides support for nurse reviewers and manages the denial process. Medical Director - Remote....