Medical Review Nurse - Plano, TX, USA

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** · JOB DESCRIPTION: · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and ...

You can Make A Difference in the lives of others · At Heart to Heart Hospice, we provide "Compassionate Care from Our Hearts to Yours." Our employees enhance the lives of patients with life-limiting illnesses and their loved ones,during a time when compassionate care is needed mo ...

We're seeking a detail-oriented and experienced Registered Nurse (RN) to join our Medical Review team. · In this role, you will use medically accepted clinical criteria to assess the medical necessity and appropriateness of treatment plans. · ...

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. · ...

Registered Nurse (RN) working in insurance industry using medically accepted criteria to validate medical necessity. · Perform accurate and timely medical review of claims suspended for medical necessity. · Initiate and/or respond to correspondence from providers or members conce ...

Job Title: Utilization Review Nurse · Location: Remote in IL, TX, NM, MT or OK · Duration: 6+ months contract · Pay: $41.50/hr on W2 · #of Openings: 8 · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and ap ...

· ***REMOTE - Candidates must be based in Texas:  Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** · JOB DESCRIPTION: · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity ...

· ***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties*** · JOB DESCRIPTION: · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity ...

Job Type · Full-time · Description · Medix Infusion is seeking a detail-oriented and compassionate Clinical Review Nurse to join our team. As an Clinical Review Nurse, you will be responsible for conducting comprehensive clinical assessments of medical records to ensure accuracy, ...

Medix Infusion is seeking a detail-oriented and compassionate Clinical Review Nurse to join our team. As an Clinical Review Nurse, you will be responsible for conducting comprehensive clinical assessments of medical records to ensure accuracy, safety, and compliance with therapy ...

This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services. · ...

RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. · ...

Job Title: · Utilization Review Nurse · Location: · Richardson, TX · Contract Duration: · 7 months · Description: · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. ...

This is a contract assignment that will start right away and end on April 30th 2024 · Review Nurse · SUMMARY DESCRIPTION: · The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and Information Set (HEDIS) su ...

Nurse reviewer I conducts preauthorization and reviews of diagnostic imaging services by utilizing appropriate policies and clinical guidelines. · ...

Nurse Reviewer I is responsible for conducting preauthorization, out-of-network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. · ...

Utilization Review Nurse for Workers' Comp · Job Purpose: · Review Workers Compensation requests submitted by the provider, requestor, claimant or carrier to determine the medical necessity of the treatment utilizing clinical expertise and evidence-based treatment guidelines. · ...

We are seeking two Clinical Review Nurses (Prior Authorization) to analyze prior authorization requests. You will provide recommendations to support quality, compliance, and cost-effective care. · Review and process prior authorization requests. · Ensure compliance with turnaroun ...

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Utilization Review Nurse-Remote-Contract · Job Summary: · We are seeking a skilled Utilization Review Nurse to join our team on a contract basis. As a remote worker, you will be responsible for performing initial and concurrent review activities, discharge care coordination, and ...