Clinical Nurse Reviewer Jobs | Glassdoor
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Clinical Nurse Reviewer Jobs

19,850 Jobs

  • 3.9
    Rush University Medical Center – Chicago, IL
    $65k-$80k(Glassdoor est.)
    Today 11hr
    your Nursing expertise and Computer talents to make a significant impact at Rush NSQIP Surgical ClinicalNurseReviewer… Office: Excel, Access and Word (testing will occur) Clinical chart review and abstraction experience required Must be very detail…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    $57k-$72k(Glassdoor est.)
    NEW
    Negotiable Experience and Education Graduate of accredited nursing program; BSN preferred. Current TX RN license; current CPR… CPR certification RN, BSN; or RN with 6 years of clinical experience and UR experience; or RN, CCM with 4 years experience in related…
  • 3.3
    Aetna – Phoenix, AZ
    NEW
    required: Registered Nurse with HEDIS medical record audit experience 3-5 years of clinical experience required Preferred… equivalent experience. LICENSES AND CERTIFICATIONS Nursing/Registered Nurse is required TECHNOLOGY EXPERIENCES Technical -…
  • 3.5
    Washington Hospital Center – Washington, DC
    Today 10hr
    Utilization ReviewNurse, assesses patient insurance/status to facilitate appropriate completion of utilization review using payer… PRIOR EXPERIENCE Three to five years experience as a clinicalnurse in an acute care setting. Prior experience in a hospital…
  • 4.4
    Central California Alliance for Health – Merced, CA
    $46k-$58k(Glassdoor est.)
    NEW
    approved by the plan; Maintaining documentation of clinicalreviews in Utilization Management (UM) software system according… concurrent and post-service review for all Alliance members in acute, sub-acute, skilled nursing and long term care facilities…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    16 days ago 16d
    Negotiable Experience and Education Graduate of accredited nursing program; BSN preferred.nnnCurrent TX RN license; current CPR… CPR certificationnnnRN, BSN; or RN with 6 years of clinical experience and UR experience; or RN, CCM with 4 years experience in…
  • 3.2
    SCL Health – Denver, CO
    $57k-$72k(Glassdoor est.)
    1 days ago 14hr
    Degree or diploma from an accredited nursing program Completion of Bachelors degree in Nursing within 5 years of your hire (for… prepared nurses) Current Colorado RN license Current BLS-HCP certification from the AHA One year of nursing experience…
  • 2.7
    Boys Town Hospital – Omaha, NE
    $51k-$66k(Glassdoor est.)
    NEW
    coding, utilization review, and/or other related healthcare experience and a minimum of five years of clinical experience with an… pertaining to utilization review, audit, billing and reimbursement activities, utilizing knowledge of both nursing and administrative…
  • 3.5
    Commonwealth Care Alliance – Boston, MA
    15 days ago 15d
    Utilization Management (UM) ReviewNurse is responsible for day-to-day timely clinical and service authorization review for medical necessity… determinations. The Utilization Management ReviewNurse reports to the Utilization Management Nurse Manager. Key Responsibilities:…
  • 4.5
    Children's Home Healthcare – Richardson, TX
    EASY APPLY
    $57k-$72k(Glassdoor est.)
    4 days ago 4d
    experienced Registered Nurse (RN) Clinical Supervisor in the Dallas area. The Registered Nurse (RN) Clinical Supervisor will be directly… requested by Administrator and/or Director of Nursing. Registered Nurse (RN) Clinical Supervisor Qualifications/Minimum Job Requirements…
  • 3.7
    Florida Hospital – Orlando, FL
    NEW
    relevant expertise to the Clinical Interdisciplinary Team comprised of psychiatrists, physicians, nurses, social workers and other… Summary Independently manages and performs clinical authorizations and reviews for patients admitted to Florida Hospital, through…
  • 3.7
    Marywood University – Scranton, PA
    EASY APPLY
    $26k-$48k(Glassdoor est.)
    1 days ago 12hr
    Department of Nursing is seeking applicants for a full time clinical faculty/lab manager position for the Undergraduate Nursing program… Master’s degree in Nursing and RN licensure in PA or eligible. Clinical experience in Medical-Surgical Nursing is required. Prior…
  • 3.4
    Presbyterian Healthcare Services – Albuquerque, NM
    7 days ago 7d
    process. Summary: Performs clinicalreview to ensure that services rendered to members meet clinical criteria and are delivered… prior authorization, medical claims review to include prospective and retrospective review, office and hospital audits), experience…
  • 4.4
    Northeastern Vermont Regional Hospital – Saint Johnsbury, VT
    $92k-$118k(Glassdoor est.)
    1 days ago 15hr
    pay period Job Details Looking for Team Oriented Nurse Practitioner to join our Practice! Highlights: · Competitive… Work! "Our medical practice has an amazing team of Providers, Nurses and Support staff that go above and beyond their daily duties…
  • 3.0
    AmeriHealth Caritas – Harrisburg, PA
    1 days ago 12hr
    requests to Clinical Care Management Supervisor. Report any treatment concerns to Clinical Care Management Supervisor. Review information… Degree. Registered Nurse. Graduate degree from an accredited educational program in Social Work, Clinical/Counseling Psychology…
  • 3.7
    Froedtert – Menomonee Falls, WI
    $58k-$72k(Glassdoor est.)
    Today 4hr
    years of nursing experience, 4-5 of which should be in an acute care setting is required. Experience in a variety of clinical settings… School of Nursing in order to be eligible for licensure as a Registered Nurse is required. Bachelor's degree in Nursing is preferred…
  • 3.3
    WellCare – Phoenix, AZ
    Today 10hr
    pre-authorization, utilization review, concurrent review, discharge planning, and/or skilled nursing facility reviews Preferred Other Care… Experience: Required 2 years of experience in a clinical setting with general nursing exposure in utilization management to include…
  • 3.9
    Phoenix Children's Hospital – Phoenix, AZ
    $58k-$78k(Glassdoor est.)
    Today 11hr
    Hemodialysis ClinicalNurse Apply! Position Details Department: Hemodialysis-Outpatient Category: Nursing/Patient… delivery of professional nursing care appropriate to patients age and condition as documented in the nursing and medical plans of…
  • 3.8
    Intermountain Healthcare – Salt Lake City, UT
    $52k-$66k(Glassdoor est.)
    1 days ago 19hr
    implementing and evaluating care of patients. The RN-Clinic utilizes the nursing process by use of technology, therapeutic intervention… patient response to interventions through review of achievement of goals, clinical outcomes, patient and family satisfaction.…
  • 3.2
    SCL Health – Butte, MT
    NEW
    results of tests are received, reviewed by physician and communicated to patients. The ClinicNurse adheres to all applicable state… In this position, the ClinicNurse provides nursing care to patients and is responsible for patient care coordination, telephone…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    $60k-$75k(Glassdoor est.)
    NEW
    or Department of Nursing policies, procedures, clinical pathways and nationally accepted standards of nursing practice. Incorporates… Graduate of an approved/accredited nursing program either by a governmental authority, nursing board, or a licensing authority which…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    $71k-$98k(Glassdoor est.)
    NEW
    other nursing and ancillary personnel. Manages staff to meet established productivity targets as appropriate. Reviews staffing… Negotiable Experience and Education Graduate of an accredited Nursing program. Must be able to read, write and communicate in English…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    $60k-$75k(Glassdoor est.)
    NEW
    or Department of Nursing policies, procedures, clinical pathways and nationally accepted standards of nursing practice. Incorporates… Graduate of an approved/accredited nursing program either by a governmental authority, nursing board, or a licensing authority which…
  • 2.5
    Novitas Solutions, Inc. – Mechanicsburg, PA
    Today 10hr
    SUMMARY STATEMENT The ClinicalReviewNurse is responsible for reviewing and making medical determinations as to the validity… health care claims from a medical perspective: o Perform clinicalreview work as assigned; may provide guidance to other team members…
  • 4.1
    CVHCare Home Health – Burbank, CA
    1 days ago 21hr
    Director of Nursing shall have strong hands-on clinical expertise, sufficient background knowledge, and expertise in clinical decision-making… Evaluate performance of clinical personnel In the absence of the Administrator, the Director of Nursing will become the acting…
  • 3.4
    Chrysalis Health – Altoona, FL
    15 days ago 15d
    closely with clinical staff to discuss need for pre-certification and clinicalreviews as well as for continuing stay reviews. Lastly… advocate for the patient. Reviews medical records and consults with the medical, psychiatric and clinical team to obtain required…
  • 3.5
    Presbyterian Homes & Services – Roseville, MN
    $59k-$83k(Glassdoor est.)
    Today 10hr
    Lead annual clinical strategic planning of educational offerings in connection with the PHS Corporate Clinical Team, Optage Home… Manage the team of L & D clinical educators to achieve PHS strategic vision/desired outcomes related to clinical staff education. Perform…
  • 3.7
    UT Southwestern Medical Center – Dallas, TX
    $60k-$75k(Glassdoor est.)
    Today 10hr
    or Department of Nursing policies, procedures, clinical pathways and nationally accepted standards of nursing practice. Incorporates… Graduate of an approved/accredited nursing program either by a governmental authority, nursing board, or a licensing authority which…
  • 4.5
    MedAvante, Inc. – United States
    HOT
    Psychology, Social Work, Counseling or Psychiatric Nursing. Minimum of 2 years clinical experience diagnosing and/or treating patients… MedAvante is the clinical data sciences company that is revolutionizing drug development with smarter, faster clinical trials. The…
  • 4.5
    MedAvante, Inc. – United States
    19 days ago 19d
    Psychology, Social Work, Counseling or Psychiatric Nursing. Minimum of 2 years clinical experience diagnosing and/or treating patients… assessments and review site scores. Review site assessments for quality assurance. Submit accurate review of site data utilizing…
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