Preservice Review Nurse RN - Tampa

Company Description · CASE HEALTH AI (CHAI) specializes in creating AI-driven solutions that automate administrative tasks for health plans, with a focus on prior authorizations. Our advanced AI tools analyze faxes, clinical documents, and guidelines to deliver accurate, explaina ...

This role enables associates to work virtually full-time, except for required in-person training sessions. · ...

Company Description · CASE HEALTH AI (CHAI) specializes in creating AI-driven solutions that automate administrative tasks for health plans, with a focus on prior authorizations. Our advanced AI tools analyze faxes, clinical documents, and guidelines to deliver accurate, explaina ...

Review approximately 20 cases a day for medical necessity. Advocate for and protect members from unnecessary hospital admissions. Follow established procedures and processes to complete authorizations. · ...

· Company Description · Why You Should Work For Us: · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positi ...

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide ...

· Company Description · HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest a ...

We are not a staffing firm or agency. Lensa partners with DirectEmployers to promote this job for UnitedHealth Group. · This role will be performing outpatient clinical coverage review services, which require interpretation of state and federal mandates, · applicable benefit lang ...

This role will be performing outpatient clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language, and consideration for outpatient procedures and services. · Function as a member of a self-directed team to meet spe ...

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. · Perform clinical coverage review services, which require interpretation of state and federal mandates, applicable benefit language, and consideration of relevant ...

Optum is a global organization that delivers care aided by technology to help millions of people live healthier lives. · You will find a culture guided by inclusion talented peers comprehensive benefits and career development opportunities. · Come make an impact on the communitie ...

Lensa is a career site that helps job seekers find great jobs in the US. · Perform clinical coverage review services · Function as a member of a self-directed team to meet specific individual and team performance metrics · ...

· Responsibilities · Perform clinical coverage review services which require interpretation of state and federal mandates applicable benefit language and consideration of relevant clinical information. · Function as a member of a self-directed team to meet specific individual an ...

GQR Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Baltimore, Maryland. · Job Description & Requirements · Specialty: · Utilization Review · Discipline: · RN · Duration: · 13 weeks · 40 hours per week · Shift: · 8 hours, days · Employment T ...

Nurse Case Reviewer · It's the details that matter ShimSpine is looking for an experienced professional to join our company as a Nurse Case Reviewer. As part of our team, you will be using a patented, industry-leading software application to analyze and develop case summaries for ...

Provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. · ...

We are looking for an experienced professional to join our team as a Part-time Nurse Case Reviewer. · ...

Part-time Nurse Case Reviewer · It's the details that matter ShimSpine is looking for an experienced professional to join our company as a Part-time Nurse Case Reviewer. As part of our team, you will be using a patented, industry-leading software application to analyze and develo ...

Prosper Infusion is hiring a Nursing Manager to help maintain high-quality care and comply with laws and regulations. This role will work out of the Tampa or Sarasota office. · ...

We are hiring for a Nursing Manager will help our Director of Nursing maintain high quality care and compliance with laws regulations and accreditation standards.This role will primarily work out of our Tampa or Sarasota office M-F 8:30a-5pm. · ...