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Clinical Review Coordinator Jobs

Clinical Coordinator Jobs
By Gift of Hope Organ & Tissue Donor Network At Illinois, United States
Other candidates may be considered on an individual basis at the discretion of management, dependent on aligned job experience
Coordinate medical management of donation after circulatory death (DCD) donors with the hospital team to ensure appropriate hemodynamic status
Support staff through the referral process and provide additional education and information surrounding the donation process as needed
Participate in departmental quality assurance initiatives, meetings, educational activities and required training as assigned
Responsible for triage of organ referrals, obtaining clinical information to determine medical suitability, providing clinical assessment to determine organ viability
Create case plan for organ referrals including further needs once onsite staff involved.
Clinical Coordinator Jobs
By Arizona College of Nursing At Phoenix, AZ, United States
Manages relationships with hospitals, skilled nursing facilities, and other clinical agency sites for nursing students to complete clinical rotations.
Bachelor’s degree required or an equivalent combination of education and experience.
Requirements include problem-solving and critical thinking skills.
Develops innovative relationships with hospital educators and leadership to provide educational services.
Maintains knowledge and understanding of the College’s curriculum and programs and can clearly explain to clinical partners.
Facilitates recruitment of appropriate clinical preceptors utilized in assigned student clinical experiences.
Clinical Coordinator Jobs
By Wellness Together At , Remote $50 - $55 an hour
Excellent interpersonal and team management skills required.
2+ years of experience in practice management and/or clinical supervision preferred.
Knowledge of school-based therapy, public education policy, and FERPA desired.
Hosting the annual Student Mental Wellness Conference which partners with the CA Department of Education
Collaborates with the Clinical Director, Clinical Manager and Clinical Supervision team as needed.
Experience with chart review and utilization review.
Dental Claim Review Coordinator
By MetLife At , Remo
Good time management and organization skills.
5 years of Dental Claims Knowledge and Experience
EDI Experience and Knowledge/ Knowledge of Provider procedures and systems
Manages critical relationships with IT, consultants/vendors, internal end users, business leaders and customers.
Prepare cost benefit analysis of proposed enhancements/efficiencies for new projects when required.
Excellent oral and written communication skills.
Quality Review Coordinator Jobs
By Baptist Health Arkansas At , Little Rock

Review Standard Operating Procedures annually

This job will be authorized 80.00 hours bi-weekly.

Clinical Coordinator Jobs
By The US Oncology Network At Germantown, KY, United States

Overview SCOPE: Under direct supervision, provides administrative and staff support services for the department. Handles administrative tasks for projects, programs or processes specific to the ...

Clinical Review Coordinator - National Remote
By Optum At , Dallas, 75202
2+ years of Case Management experience
Experience in acute care, rehab, OR skilled nursing facility environment
Ability to work effectively in a self- management environment
Support new delegated contract start - up to ensure experienced staff work with new contracts
Perform other duties and responsibilities as required, assigned or requested
3+ years of clinical experience
Manager Clinical Quality Review
By Johns Hopkins University At , Baltimore, 21218

EDUCATION LICENSURE & EXPERIENCE :

Benefits can be viewed here:

Medical Review Nurse (Government Outpatient Clinical Focus)
By Performant Financial Corporation At , Remote
Experience with utilization management systems or clinical decision making tools such as Medical Coverage Guidelines (MCG) or InterQual.
Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse
Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits
Strong preference for experience performing utilization review for an insurance company, Tricare, MAC or organizations performing similar functions
Experience with ICD-9, ICD-10, CPT-4 or HCPCS coding.
Knowledge of insurance programs program, particularly the coverage and payment rules.
Dental Claim Review Coordinator
By MetLife At United States
Good time management and organization skills.
5 years of Dental Claims Knowledge and Experience
EDI Experience and Knowledge/ Knowledge of Provider procedures and systems
Manages critical relationships with IT, consultants/vendors, internal end users, business leaders and customers.
Prepare cost benefit analysis of proposed enhancements/efficiencies for new projects when required.
Excellent oral and written communication skills.
Medical Review Nurse (Government Outpatient Clinical Focus)
By Performant Corp At United States
Experience with utilization management systems or clinical decision making tools such as Medical Coverage Guidelines (MCG) or InterQual.
Working collaboratively with the audit team to identify and obtain approval for particular vulnerabilities and/or cases subject to potential abuse
Work in partnership with our clients, CMD colleagues, and other contractors on improving medical policies, provider education, and system edits
Strong preference for experience performing utilization review for an insurance company, Tricare, MAC or organizations performing similar functions
Experience with ICD-9, ICD-10, CPT-4 or HCPCS coding.
Knowledge of insurance programs program, particularly the coverage and payment rules.
Clinical Review Nurse I
By Elevance Health At Hingham, MA, United States
Medicare Part B Appeals experience preferred.
Job Family: Medical and Clinical
Conducts investigations and reviews of member and provider grievances and appeals.
Generates appropriate written correspondence to providers, members, and regulatory entities.
Ensures that appeals and grievances are resolved timely to meet regulatory timeframes.
Adapts to a wide variety of medical review topics in Part B appeals.
Clinical Review Nurse I
By Elevance Health At Atlanta, GA, United States
Medicare Part B Appeals experience preferred.
Job Family: Medical and Clinical
Conducts investigations and reviews of member and provider grievances and appeals.
Generates appropriate written correspondence to providers, members, and regulatory entities.
Ensures that appeals and grievances are resolved timely to meet regulatory timeframes.
Adapts to a wide variety of medical review topics in Part B appeals.
Medical Review Coordinator Jobs
By AllMed Healthcare Management At Portland, Oregon Metropolitan Area, United States
Who is AllMed Healthcare Management?
Outstanding interpersonal, teamwork, and verbal communication skills.
Excellent computer skills in a Microsoft Windows environment and the ability to pick up new software programs.
Excellent benefits to keep you healthy with medical, dental, vision, life, and disability insurance, plus company paid parking or monthly transit.
minimum of 1 year of related experience
Ensure accurate and efficient compression and organization of medical records to eliminate duplicate and extraneous information for peer reviewers.
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 & Documentation Review Consultant
By Kaiser Permanente At Oakland, CA, United States
Must be able to work in a Labor/Management Partnership (union) environment.
Bachelor's degree in health information management, business administration, healthcare administration or other related field.
Acts as the Reg-l coding contact person for the HIM Dept to support Edu & coding requirements.
High School Diploma or General Education Development (GED) required.
Demonstrated strong interpersonal and communication skills.
Working knowledge of Hierarchical Condition Category (HCC) coding and reimbursement methodology.
Clinical Review Coordinator - Remote | Wfh
By Get It Recruit - Healthcare At Dallas, TX, United States

We are seeking a passionate and dedicated healthcare professional to join our dynamic team! As a member of our organization, you will play a pivotal role in ensuring the highest quality of care for ...

Medical Review Coordinator (Intake Coordinator)
By AllMed Healthcare Management At Portland, Oregon Metropolitan Area, United States
Who is AllMed Healthcare Management?
Outstanding interpersonal, teamwork, and verbal communication skills.
Excellent computer skills in a Microsoft Windows environment and the ability to pick up new software programs.
Excellent benefits to keep you healthy with medical, dental, vision, life, and disability insurance, plus company paid parking or monthly transit.
Ensure accurate and efficient compression and organization of medical records to eliminate duplicate and extraneous information for peer reviewers.
Prepare and organize clinical information and review criteria for peer review.
Clinical Review Coordinator - National Remote
By RemoteWorker US At Hartford, CT, United States
2+ years of Case Management experience
Experience in acute care, rehab or skilled nursing facility environment
Ability to work effectively in a self-management environment
Support new delegated contract start-up to ensure experienced staff work with new contracts
Perform other duties and responsibilities as required, assigned or requested.
3+ years of clinical experience
Claims Review Coordinator Jobs
By BlueCross BlueShield of South Carolina At Columbia, SC, United States
Communicate with members, providers and/or external organizations regarding appeals status or questions. Address critical inquiries from senior management through research.
Associate Degree or 2 years of job related work experience.
3 years of experience processing, researching and adjudicating claims.
Subsidized health plans, dental and vision coverage
401K retirement savings plan with company match
On-site cafeterias and fitness centers in major locations