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Registered Nurse Clinical Reviewer Jobs in Iowa

Clinical Qa Supervisor - Registered Nurse (Remote)
By Maximus At , Remote
Prepare weekly updates for QA Management regarding staff productivity
Knowledge of quality assurance, industry quality standards and auditing processes, training tools, research and analytical skills
Ability to successfully manage priorities; excellent organizational skills
Implement department/team goals identified by IPP QA Manager. Identify and set individual/team goals, supervise the completion of the goals
Manage the timecards, assignments, and time off requests of assigned staff
Ensure IPP QA staff maintain updated knowledge of policy and procedure changes
Nurse Reviewer I Jobs
By Elevance Health At , Cerritos, 90703, Ca
Previous utilization and/or quality management and/or call center experience preferred.
Documents the results of the initial clinical review and determination in the pre-certification computer system
Candidates must have good computer skills and solid typing speed and accuracy.
Nurse Reviewer I Preferred Qualifications:
Nurse Reviewer (Level I) Soft Skills:
Job Family: Medical and Clinical
Clinical Nurse Reviewer Jobs
By Zelis At , Remote
Currently possess (or be willing to obtain) knowledge of principles of total Quality Management and continuous improvement
Support cost containment by identifying potential Case Management or Disease Management placement
One year (1) prior managed care experience preferred
Conducts initial clinical reviews for pre-certification/retro/concurrent reviews
Attend professional training educational programs every year to maintain current licensure
Three to five years (3-5) clinical experience is required
Registered Nurse, Cdi (Clinical Documentation Improvement)
By Northside Hospital Inc. At , Cumming, 30041, Ga
Ability to interact with a wide range of personnel (treating physicians, nurses, CDISs, case managers, quality staff, and coders).
Excellent oral and written communications skills.
Experience in CQI concepts and tools and techniques.
Current RN license in Georgia.
Ability to interact with numerous facilities and departments. Proficiency in Excel and Word.
Clinical Care Reviewer, Utilization Management Review, Registered Nurse, Remote
By AmeriHealth Caritas At , Remote
Experience performing utilization management reviews (prior authorization and concurrent reviews) in a managed care organization.
3 or more years of experience in a related clinical setting as a Registered Nurse.
Strong written and verbal communication skills.
Associate’s Degree required; Bachelor’s Degree preferred.
Current unrestricted North Carolina or compact Registered Nurse license required.
Proficiency utilizing MS Office and electronic medical record and documentation programs.
Rn- Initial Clinical Reviewer
By Evolent Health At , Remote $33 an hour
Practices and maintains the principles of utilization management by adhering to policies and procedures.
Continue to prioritize the employee experience and achieved a 90% overall engagement score on our employee survey in May 2022.
Strong interpersonal and communication skills.
Basic computer skills; must be able to talk and type simultaneously.
The Experience You’ll Need (Required):
We continue to grow year over year.

Are you a Registered Nurse looking for a new challenge? Join our team as a Clinical Reviewer and use your expertise to help improve patient care! As a Clinical Reviewer, you will be responsible for evaluating medical records, assessing patient care, and providing feedback to healthcare providers. Take the next step in your career and make a difference in the lives of patients!

Overview Registered Nurse Clinical Reviewers are responsible for reviewing medical records and other documents to ensure accuracy and compliance with regulations. They are responsible for providing feedback to healthcare providers and other stakeholders on the quality of care provided. They must be knowledgeable of medical terminology, coding, and regulatory requirements. Detailed Job Description Registered Nurse Clinical Reviewers are responsible for reviewing medical records and other documents to ensure accuracy and compliance with regulations. They must be knowledgeable of medical terminology, coding, and regulatory requirements. They must be able to interpret and analyze medical records and other documents to ensure accuracy and compliance with regulations. They must be able to provide feedback to healthcare providers and other stakeholders on the quality of care provided. They must be able to identify and address any discrepancies or errors in the medical records. They must be able to communicate effectively with healthcare providers and other stakeholders. Job Skills Required
• Knowledge of medical terminology, coding, and regulatory requirements
• Ability to interpret and analyze medical records and other documents
• Ability to provide feedback to healthcare providers and other stakeholders
• Ability to identify and address discrepancies or errors in medical records
• Ability to communicate effectively with healthcare providers and other stakeholders
• Ability to work independently and as part of a team
• Ability to prioritize tasks and manage time effectively
Job Qualifications
• Bachelor’s degree in Nursing or related field
• Current Registered Nurse (RN) license
• At least two years of experience in a clinical setting
• Knowledge of medical terminology, coding, and regulatory requirements
• Knowledge of medical record review and analysis
• Knowledge of quality improvement processes
• Excellent communication and interpersonal skills
• Strong organizational and problem-solving skills
Job Knowledge
• Knowledge of medical terminology, coding, and regulatory requirements
• Knowledge of medical record review and analysis
• Knowledge of quality improvement processes
• Knowledge of healthcare industry trends and best practices
Job Experience
• At least two years of experience in a clinical setting
• Experience in medical record review and analysis
• Experience in quality improvement processes
• Experience in providing feedback to healthcare providers and other stakeholders
Job Responsibilities
• Review medical records and other documents to ensure accuracy and compliance with regulations
• Interpret and analyze medical records and other documents to ensure accuracy and compliance with regulations
• Provide feedback to healthcare providers and other stakeholders on the quality of care provided
• Identify and address discrepancies or errors in