Jobs 1 - 20 out of 154 for Clinical Reviewer

Top Companies Hiring for Clinical Reviewer (Page 1 of 8)

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Greenlife Healthcare Staffing
RN Clinical Reviewer
11590, Westbury, NY, US
Onsite
Full-time
$60–$60/hour
3 days ago
Perform clinical reviews and abstractions of assigned cases related to maternal death or adverse events during outpatient surgical procedures. Conduct clinical reviews of medical records, develop narrative summaries, and track case status in Excel and other databases.
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Greenlife Healthcare Staffing
RN Clinical Reviewer
12084, Guilderland, NY, US
Onsite
Full-time
$60–$60/hour
3 days ago
Conduct clinical reviews of medical records related to maternal deaths or adverse events during outpatient surgical procedures. Develop narrative summaries of clinical reviews and track case status in Excel and other databases.
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Greenlife Healthcare Staffing
RN Clinical Reviewer
12202, Albany, NY, US
Onsite
Full-time
$60–$60/hour
3 days ago
Perform clinical reviews and abstractions of assigned cases related to maternal deaths or adverse events occurring during outpatient surgical procedures. Conduct clinical reviews of medical records, develop narrative summaries, and track case status in Excel and other databases.
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University Health
Clinical Reviewer, Utilization Management
Boerne, TX, US
3 days ago
POSITION SUMMARY/RESPONSIBILITIES Assists Community First Health Plan (CFHP) members regain optimum health or improved functional capacity by ensuring that members have access to all of the health care services they need in the most efficient and effective manner possible. Responsibilities include ...
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Greenlife Healthcare Staffing
Registered Nurse Clinical Reviewer / IDR
11590, Westbury, NY, US
Onsite
Full-time
$60–$60/hour
3 days ago
Conduct reviews up to and including the appeal level, including chart screens, compiling regulatory guidance, researching insurer requirements, completing electronic worksheets, and preparing final determinations. Act as a resource for administrative and clinical staff in training, problem-solving, ...
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Cigna Group
Utilization Management Clinical Reviewer (California)
California, US
Remote
Full-time
$31–$52/hour
5 days ago
Manage an active caseload, assess clinical needs and levels of care, identify barriers to discharge, and coordinate safe transitions across the care continuum. Collaborate with members, families, providers, and internal partners while balancing quality, affordability, benefit coverage, and member ad...
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The Cigna Group
Utilization Management Clinical Reviewer (California) - Remote
94278, Sacramento, CA, US
Remote
Full-time
$31–$52/hour
4 days ago
Manage an active caseload, assess clinical needs and levels of care, identify barriers to discharge, and coordinate safe transitions across the care continuum. Collaborate with members, families, providers, and internal partners while balancing quality, affordability, benefit coverage, and member ad...
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CBIZ
RN Clinical Reviewer
Indiana, US
Remote
Full-time
13 days ago
Review resident medical records for accuracy, completeness and consistency with professional standards. Participate in remote and on-site field examinations of Medicaid providers to review clinical documentation. Maintain security and confidentiality of all Protected Health Information (PHI).
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Point32Health
Clinical Reviewer, Behavioral Health
Canton, MA, US
Onsite
Full-time
$80.4k–$120.6k/year
13 days ago
Conduct benefit coverage reviews and utilization management according to regulatory guidelines. Collaborate with Behavioral Health leadership to improve service and reduce costs. Escalate urgent issues impacting member needs and ensure compliance with clinical requirements.
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Cohere Health
Clinical Reviewer, DPT
United States
Remote
Full-time
$95k–$105k/year
16 days ago
Deliver on Cohere’s musculoskeletal and orthopedic programs by determining the medical appropriateness of services through clinical information review and evidence-based guidelines. Provide timely medical reviews, document communication and decision-making, conduct peer-to-peer discussions with prov...
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Nexus Health Systems
Clinical Reviewer
77056, Houston, TX, US
Onsite
Full-time
22 days ago
The Clinical Reviewer reviews medical records, clinical histories, assessments, and referral documentation to determine clinical appropriateness and program fit. This position develops thorough, high-quality clinical evaluations and summaries that support admission and authorization decisions while ...
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Broadway Ventures
Home Health/Medicare RCD Clinical Reviewer
United States
$65/hour
13 days ago
Conduct comprehensive reviews of home health pre-claim review packages to determine compliance with Medicare coverage, coding, and payment criteria. Document review outcomes with well-defined clinical rationale in the designated case management system, ensuring a turnaround time of within 7 business...
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University of Chicago
Senior Surgical Clinical Reviewer
United States
Remote
Full-time
25 days ago
The Senior Surgical Clinical Reviewer’s chief responsibility is to ensure reliable data is collected and submitted to the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP). This includes high-quality data compilation, documentation, and entry into the ACS NSQIP...
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Comagine-Health
Clinical Reviewer (PT or OT-Licensed)
United States
Remote
Full-time/Part-time
22 days ago
Clinical Reviewers evaluate authorization requests and supporting medical records for medical necessity and appropriateness, applying treatment guidelines and clinical criteria. They document decisions, manage cases, and communicate with clinics and internal teams.
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UChicago Medicine
Senior Surgical Clinical Reviewer
Illinois, US
Remote
Full-time
27 days ago
Ensure reliable data is collected and submitted to the ACS NSQIP through high-quality data compilation, documentation, and entry. Oversee Adult and Pediatric NSQIP programs, facilitate quality improvement initiatives, and audit surgery cases. Prepare clinical quality reports and serve as an educatio...
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Watson Clinic
Clinical Reviewer - Ma - Full Time
33815, Lakeland, FL, US
Onsite
Full-time
29 days ago
The Clinical Reviewer uses their medical knowledge to identify and address quality gaps and assist with the coordination of care for the Clinic’s patients. This role produces, abstracts, and submits data, and works from portals, spreadsheets, and databases to support quality projects and Value Based...
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Ohio Living
Clinical Reviewer - Medical Coder & QA
Ohio, US
Onsite
Full-time
about 1 month ago
The Clinical Reviewer reviews and approves patient information provided by licensed professionals during care visits, ensuring quality patient care and compliance with standards. Responsibilities include processing Home Health Starts of Care, maintaining productivity benchmarks, reviewing clinical d...
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PIKEVILLE MEDICAL CENTER INC.
CLINICAL REVIEWER URGENT CARE WELLNESS CLINIC
41501, Pikeville, KY, US
Onsite
Full-time
about 1 month ago
Uses clinical knowledge to ensure that healthcare services meet regulatory and quality standards. Serves as an advisor to providers and staff regarding complete and accurate documentation supporting services provided. Collaborates with providers and clinical staff to deliver education on documentati...
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MedRisk
Clinical Reviewer
United States
about 2 months ago
A PT, MPT or DPT Clinical Reviewer is responsible for reviewing medical records, patient information, and treatment plans to ensure compliance with clinical guidelines and standards. They also provide tele-services, such as physical therapy consultations, to patients remotely.
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Covenant Health
Neurosurgery Nurse Navigator & Surgical Clinical Reviewer
United States
Onsite
Full-time
$69.5k–$95.8k/year
about 2 months ago
The Neurosurgery Nurse Navigator & Surgical Clinical Reviewer serves in a dual role supporting neurosurgical patients and surgical quality improvement initiatives. Responsibilities include coordinating patient care, managing transitions, providing education, collecting clinical data, and supporting ...
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Jobs 1 - 20 out of 154 for Clinical Reviewer

Top Companies Hiring for Clinical Reviewer (Page 1 of 8)

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