Click to search for jobs

Summary

Summary
We are currently hiring for a Senior Medical Reviewer to join CGS, a Celerian Group Company and subsidiary of BlueCross BlueShield of South Carolina. In this role you will Act as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training t...

Summary
We are currently hiring for a Senior Medical Reviewer to join CGS, a Celerian Group Company and subsidiary of BlueCross BlueShield of South Carolina. In this role you will Act as Team Lead for specialty programs, medical review, utilization management, and case management areas by providing assistance and support to unit supervisor/manager by giving direction/guidance/training t...

Company Overview
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership ...

Job Details
Level: Experienced Job Location: California Office - Roseville, CA Position Type: Full Time Education Level: Bachelor's Degree Salary Range: $75000.00 - $85000.00 Salary/year Travel Percentage: None Job Shift: Day Job Category: Insurance
Medical Itemized Bill Reviewer (IBRL-1 Analyst)
Who We Are
Machinify is a leading healthcare intelligence company wi...

Current Employees:
If you are a current Staff, Faculty or Temporary employee at the University of Miami, please click here to log in to Workday to use the internal application process. To learn how to apply for a faculty or staff position using the Career worklet, please review this tip sheet .
The Concurrent Quality Reviewer of our hospital reviews documentation in the electronic medical...

Responsibilities:
Under the direction of the supervisor, the Clinical Care Reviewer UM is responsible for completing medical necessity reviews. Using clinical knowledge and experience, the Clinical Care Reviewer UM reviews the provider requests for inpatient and outpatient services, working closely with members and providers to collect all information necessary to perform a thorough medi...

JOB TITLE (# 25032 ): Registered Nurse / Women's Health (Tier 3) / VA Reviewer - Remote
Minimum of 5 years active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking a Women's Health Registered Nurse - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Registered Nurse / Women's Health...

JOB TITLE (#25164) : Nurse Practitioner / Med/Surg (Tier 3) / VA Reviewer - Remote
Minimum of 5 years of active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking a Med Surg Nurse Practitioner - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Nurse Practitioner / Med/Surg (Tier 3) ...

JOB TITLE (# 25023 ): Emergency NP / VA Reviewer - Remote
Minimum of 5 years active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking an Emergency Nurse Practitioner - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Emergency NP / VA Reviewer :
* Must hold a current, non-...

Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a ...

Job Description
Location: Remote
Duration: 4 months contract (with possible extension)
*Notes: Fully remote, MA license required.
Job Summary The Clinical Reviewer is a licensed professional –a Registered Nurse preferred– that is expected to function independently in her / his role and is responsible for managing a clinically complex caseload of varied requests for services. The Cli...

Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, a...

The Surgery Clinical Reviewer coordinates, collects, and submits reliable and accurate clinical data to the American College of Surgeon’s National Surgical Quality Improvement Program (NSQIP), through high-quality, complex clinical data interpretation, abstraction, and data validation. This position obtains data via standard and custom reports, analyzes, interpret data's, and identifies opportu...

Company Overview
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing cli...

Company Overview
At Enlyte, we combine innovative technology, clinical expertise, and human compassion to help people recover after workplace injuries or auto accidents. We support their journey back to health and wellness through our industry-leading solutions and services. Whether you're supporting a Fortune 500 client or a local business, developing cutting-edge technology, or providing cli...

POSITION: Director of Procurement
DEPARTMENT: Procurement
REPORTS TO: VP of Procurement
FLSA STATUS: Exempt
LEGENDS & ASM GLOBAL
Two powerhouse companies have joined forces to redefine excellence in sports, entertainment, and live events. Together, we combine unmatched expertise with a global reach, offering end-to-end solutions – from venue developmen...

The Data Reviewer Specialist acts as a contributing specialist for studies, with the ability to carry out aspects of data review, expediting audit responses, and reporting (data reviewing with minimal guidance) through report finalization. The Data Reviewer Specialist has excellent organizational skills and utilizes a strong base in regulatory policy to assess data review and reporting and main...

Electrophysiology Technologist ACUTE (SME) Clinical Content Writer/Reviewer
Are you an Electrophysiology Technologist looking to flex your skills in a whole new way? Ready to take your acute care expertise and turn it into a rewarding, flexible opportunity? Look no further!
We're seeking an experienced Electrophysiology Technologist with a passion for clinical excellence and a flair for writin...

The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.
The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements, company bes...