Nurse Reviewer Jobs | Glassdoor
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Nurse Reviewer Jobs

  • 3.6
    Commonwealth Care Alliance – Boston, MA
    12 days ago 12d
    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:…
  • 4.4
    Central California Alliance for Health – Scotts Valley, CA
    Est. Salary $82k-$101k
    4 days ago 4d
    concurrent and post-service review for all Alliance members in acute, sub-acute, skilled nursing and long term care facilities… sub-acute, skilled-nursing and long-term care facilities to perform concurrent and/or retrospective review; Knowledge of Utilization…
  • 4.5
    ViziRecruiter – Detroit, MI
    21 days ago 21d
    Healthcare Company and they are searching for a Utilization ReviewNurse To learn more, please click on the 'apply on company website… website' button above. Keywords: Healthcare, Medical, Nursing, Patient Care…
  • 3.0
    Shire Pharmaceuticals LLC – Cambridge, MA
    5 days ago 5d
    Bachelor’s degree for Nursing Bachelor’s degree or Pharm D for Pharmacy Preferred Degree: Nursing: Bachelor’s degree… Electronic Case Report Form review, SAE form creation, request Argus study configuration and management/review of other study related…
  • 4.6
    Residential Home Health and Residential Hospice – Downers Grove, IL
    13 days ago 13d
    full-time Episode Review Specialist for our office located in Downers Grove, Illinois. SUMMARY: The End of Episode Nurse is responsible… Must possess an Associate Degree from an accredited School of Nursing Minimum of two (2) years experience in home health care…
  • 3.2
    Molina Healthcare – Columbus, OH
    Est. Salary $55k-$70k
    NEW
    a Registered Nurse with a Bachelors Degree in Nursing. You will be a part of a dynamic team of Registered Nurses who will be reviewing… Education Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred. Required Experience 3 years hospital…
  • 3.2
    MemorialCare Health System – Fountain Valley, CA
    27 days ago 27d
    Education California Registered Nurse (RN) preferred. Licensed Vocational Nurse (LVN) with consideration made based on… Utilization Review Management process to ensure continuity of care throughout the health care continuum including review and authorization…
  • 3.4
    University of Massachusetts Medical School – Shrewsbury, MA
    6 days ago 6d
    direction of the Associate Director or their designee, the NurseReviewer will support MassHealths Community Case Management program… Licensed Practical Nurse with current license in the Commonwealth of Massachusetts and 6 years clinical nursing experience Demonstrated…
  • 2.8
    MAXIMUS – Columbia, SC
    NEW
    member, as well as independently Four year nursing degree preferred; Medicare Medical Review or appeals experience in Medicare Part… Performs other duties as assigned by leadership Registered Nurse degree with active license in SC BSN preferred 2 years of…
  • 3.5
    Washington Hospital Center – Washington, DC
    4 days ago 4d
    Utilization ReviewNurse, assesses patient insurance/status to facilitate appropriate completion of utilization review using payer… communication liaison between registered nurse case managers, social workers, on-site reviewers, patient financial services, outpatient…
  • 3.4
    L.A. Care Health Plan – Los Angeles, CA
    Est. Salary $83k-$107k
    5 days ago 5d
    /Acute care nursing experience  Must obtain and maintain successful completion of a DHCS Certified Site Reviewer and/or DHCS… care and service to members. Conducts various types of site reviews of PCP and specialist sites to ensure quality FSR and physician…
  • 3.6
    Commonwealth Care Alliance – Boston, MA
    Est. Salary $71k-$93k
    15 days ago 15d
    MDS Reviewer is a member of the Minimum Data Set (MDS) Clinical Review team of the Care Planning Unit. The RN MDS Reviewer supports… Qualifications: Associate's Degree in Nursing, required Bachelor's Degree in Nursing, preferred Knowledge of MDS strongly preferred…
  • 3.2
    MemorialCare Health System – Long Beach, CA
    Est. Salary $38k-$53k
    Today 11hr
    utilization review, case management or discharge planning will also be considered. Current California Registered Nurse License.… utilization review, case management or discharge planning will also be considered. Current California Registered Nurse License.…
  • 4.4
    Central California Alliance for Health – Merced, CA
    Est. Salary $67k-$135k
    8 days ago 8d
    Performs duties as a UM Concurrent ReviewNurse, as needed; Assists UM Manager - Concurrent Review and department Director in preparation… Concurrent ReviewNurse, as needed, with duties including but not limited to: Providing UM Concurrent Review coverage in…
  • 4.5
    ViziRecruiter – Detroit, MI
    20 days ago 20d
    Trusted Health Plan is looking to fill an open Utilization ReviewNurse position. To learn more about this position, please click…
  • 2.9
    Kinnser Software – Biloxi, MS
    14 days ago 14d
    Current nursing registration Minimum of 1-2 years nursing experience Minimum of 1-2 years of coding/OASIS review experience… REQUIREMENTS: PPS Plus Software requires that the OASIS ReviewNurse hold two designations: Homecare Coding Specialist Diagnosis…
  • 4.3
    Healthcare Support – Boise, ID
    NEW
    Job Description Are you an experienced Utilization ReviewNurse looking for a new opportunity with a prestigious healthcare company… you! Daily Responsibilities: The Utilization ReviewNurse will be Provide utilization management services which promote…
  • 3.5
    Mercy – Springfield, MO
    12 days ago 12d
    Qualifications: Education: Registered Nurse or Licensed Practical Nurse and current RN/LPN license in our state. Basic… a team and love working that way. We have opportunities for nurses who are inspired to pioneer new models of care and want to transform…
  • 2.4
    Garretson Resolution Group – Charlotte, NC
    EASY APPLY
    NEW
    graduate with state law license (preferred) Registered nurse with medical review experience (e.g. HEDIS) (preferred) Medical and/… Legal Document Analyst performs moderately complex tasks by reviewing evidence submitted from Class Members pursuant to a class…
  • 3.5
    Presbyterian Healthcare Services – Albuquerque, NM
    Est. Salary $58k-$74k
    19 days ago 19d
    Credentials: Registered Nurse - State of New Mexico or Compact State Nursing License or Graduate Nurse Permit required. BLS certification… Associate Degree in Nursing (BSN completion within 5 years of hire) Degree from accredited academic nursing program (If a program…
  • 4.5
    MedAvante, Inc. – United States
    19 days ago 19d
    Submit accurate review of site data utilizing standardized conventions. Utilize technology required to review and score site… MedAvante Project Associates to schedule assessment reviews, submit appropriate review documentation and provide data clarification.…
  • 3.8
    CSI Professional – Westerville, OH
    9 days ago 9d
    thecsicompanies.com MAJOR: The CSI Companies is currently seeking a NurseReviewer for a well known client in the Westerville, OH area. MAJOR… required- 1+ year utilization review experience preferred MAJOR: - Must have SNF *Skilled Nurse Facility experience. MAJOR: -…
  • 3.3
    Regal Medical Group – Northridge, Clark, OH
    Est. Salary $53k-$67k
    Today 6hr
    to the Regional Medical Director, NurseReviewer is responsible for performing case reviews base on key screening outpatient indicators… Download Application Submit Completed Application NurseReviewer, LVN/RN - Northridge Description As one of the fastest…
  • 3.5
    Lehigh Valley Health Network – Allentown, PA
    NEW
    great place to work. Join us in applying for our Clinical NurseReviewer Surgery position in the Department of Surgery. Be part… Manager for NSQIP and Quality Improvement, the Clinical NurseReviewer will support clinical activities related to the implementation…
  • 3.8
    FirstLight HomeCare Franchising, LLC – Cheektowaga, NY
    EASY APPLY
    Est. Salary $43k-$55k
    NEW
    Registered Nurse (RN) JOB SUMMARY: The Registered Nurse at FirstLight HomeCare performs aide introductions, oversees the… school of professional nursing and currently licensed in the state of New York. Two (2) years in-home nursing experience, preferred…
  • 3.8
    CSI Professional – Westerville, OH
    NEW
    in 1994. Currently, we are seeking to hire 2 Behavioral NurseReviewers for a contract-to-hire opportunity in Westerville, OH.… medical record reviews, data collection and database entry. Assigns case reviews by identifying the issues for review and the specialty…
  • 4.5
    Children's Home Healthcare – Albuquerque, NM
    EASY APPLY
    Est. Salary $56k-$70k
    NEW
    include, but are not limited to, private duty nursing, pediatric skilled nursing care, neonatal care, ventilator and tracheostomy… basis per company policy. Review/approve plan of care and all related documents prior to physician review/signing. Provide patient…
  • 4.4
    Independence Village – Midland, MI
    Est. Salary $18k-$24k
    NEW
    Memory Care Nursing Assistant Independence Village of Midland Position Summary: As a Nursing Assistant you are… residents in a senior living community. Required Experience for Nursing Assistant: High School Diploma or GED preferred. Previous…
  • 3.5
    Computer Task Group – Charlestown, MA
    NEW
    NurseReviewer CTG's premier client has an immediate opening for a NurseReviewer for a 6 Months Contract assignment. The right… license and experience with Utilization Review within SNF. Position Title: NurseReviewer Duration: 6 Months Location: Charlestown…
  • 3.5
    Carolinas HealthCare System – Concord, NC
    5 days ago 5d
    admission and concurrent reviews. Applies clinical guidelines during Admission and Concurrent reviews and identifies potential… and Certifications Graduation from an accredited School of Nursing. NC RN licensure required. Related experience preferred. Basic…
  • 3.3
    Centura Health – Westminster, CO
    Est. Salary $59k-$76k
    7 days ago 7d
    improvement, and refers to CMO or PA or Third Party Reviewer for peer review as needed.* Tracks avoidable days using case management… reversals.* Performs utilization review in accordance with UM Plan to include concurrent/retro reviews and verify admission/bed status…
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