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Clinical Review Rn Jobs

Medical Review Rn -Experienced - Home Or Office Based
By Qlarant At Dallas, TX, United States
Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness.
ICD-9 coding, CPT coding, and knowledge of Medicare and/or Medicaid regulations preferred. CPC or similar certification preferred.
Completes desk review or field audits to meet applicable contract requirements and to identify evidence of potential overpayment or fraud.
Consults with Benefit Integrity investigation experts and pharmacists for advice and clarification.
Responsible for case specific or plan specific data entry and reporting.
Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data.
Clinical Coordinator Rn Jobs
By Loretto At Syracuse, NY, United States
Proven organizational and time management skills.
Identifies systems/processes in need of improvement and makes recommendations to Director of Site Operations, Program Director or Nurse Manager.
Uses effective communication skills, such as, active listening, unbiased and nonjudgmental language, and open communication style with all staff.
Uses effective communication and critical thinking skills during conflict resolution, problem solving, decision making, and other complex dialogues.
Ensures adequate skills, training and development among staff.
3+ years nursing experience preferably in long term/acute care.
Rn Clinical Leader Jobs
By Edward-Elmhurst Health At Naperville, IL, United States
Current CPR Certification issued by the American Heart Association
Baccalaureate Degree or higher in Nursing – (Incumbents hired after September, 2011)
Current State of Illinois Registered Nurse license
Rn Clinical Nurse Jobs
By United Health Care Staffing At Culbertson, MT, United States
Active RN license along with active certification required.
1 year Acute or SNF Rehab experience
Someone who has clinic experience, experience with donning/doffing PPE and has performed specimen collection and processing
Type: Full Time / Perm Contingent
Facility Salary: $74,900 to $97,800 (negotiable as per interviwe)
United Health Care Staffing, Inc.
Rn Clinical Nurse Jobs
By United Health Care Staffing At Pahala, HI, United States
Active RN license along with active certification required.
1 year Acute or SNF Rehab experience
Someone who has clinic experience, experience with donning/doffing PPE and has performed specimen collection and processing
United Health Care Staffing, Inc.
Clinical Specialist-Rn Jobs
By Vitalant At Pittsburgh, PA, United States
Knowledge of rationale and techniques relating to assigned duties required.
Registered Nurse license in state of practice required. Current CPR certification required. Valid driver’s license required.
Medical, dental, and vision insurance
401K retirement savings plans + 5% company match
Tuition assistance up to 5K per year
Free basic life and AD&D insurance
Clinical Coordinator - Rn
By Archbold Medical Center At Quitman, GA, United States

Clinical Coordinator/RN (BCH) Position DescriptionEducation Requirements: Graduate of a school of Professional Nursing. Licensed by the Georgia Board of Nursing. Current certification in Basic Life ...

Clinical Review Nurse Jobs
By Abbott At Kansas City, MO, United States
3-5 years’ minimum experience in Occupational health settings, hospital, and outpatient nursing
Career development with an international company where you can grow the career you dream of.
Free medical coverage for employees* via the Health Investment Plan (HIP) PPO
An excellent retirement savings plan with high employer contribution
Provide subject matter expertise in executing Drug Testing Services across Workplace Solutions broad customer base.
Interpret and report results of Workplace clients consistent with Workplace Solutions written Standard Operating Procedures.
Clinical Assessor (Rn) Jobs
By Acentra Health At Greenville, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Rn Clinical Bethel, Ak
By Quality Clinicians At Bethel, AK, United States
Current and valid medical state license/certifications.
Minimum of one year professional experience in similar medical setting
Strong problem solving and critical thinking skills
Administer care to ill, injured, or disabled patients
Implement patient treatment plans as directed by provider
Monitor and report changes in patient symptoms or behavior
Clinical Assessor (Rn) Jobs
By Acentra Health At Wilmington, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Kenansville, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Asheboro, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Asheville, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Black Mountain, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Jacksonville, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Durham, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Weaverville, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Raleigh, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.
Clinical Assessor (Rn) Jobs
By Acentra Health At Charlotte, NC, United States
Consult, when necessary, with the Beneficiary’s selected case management entity to generate an approvable service plan.
Are you an experienced Clinical Assessor looking for a new challenge?
Minimum of two years’ experience in home care setting preferred.
Knowledge of North Carolina Medicaid Clinical Coverage Policy (Clinical Policy) 3L and PCS Program Provider Manual
Knowledge of standards of practice related to Medicaid-funded Personal Care Services, home and community-based services (HCBS) programs, and EPSDT.
Knowledge and understanding of public sector services and supports.