Clinical Reviewer - New York, NY

We are seeking an experienced Clinical Quality Reviewer to support an annual Medical Record Review initiative. · The reviewer will play a key role in meeting state and federal reporting requirements, including submissions to the New York State Department of Health and CMS. · Main ...

Pride Health offers a clinical reviewer position requiring a bachelor's degree in healthcare with 5yrs experience in inpatient care. · ...

Surgical Clinical Reviewer position available in Flushing NY for 3 months with possible extension. Bachelor's degree in healthcare required along with min 5 yrs clinical exp and previous experience w/ American College of Surgeons National Surgical Quality Program. · ...

We are looking for a Clinical Reviewer to join our team to train AI models. · Responsibilities · Give AI chatbots diverse and complex healthcare related problems and evaluate their outputs · Evaluate the quality produced by AI models for correctness and performance · Ensure the m ...

We are seeking for a Clinical Quality Reviewer – Seasonal to perform medical record audits for compliance with HEDIS, QARR, and Medicare Advantage Star specifications. Maintain knowledge of medical record review and EMR systems. · Stay current on HEDIS, QARR, and Star measure spe ...

The primary function of the Clinical Quality Reviewer - Seasonal is to conduct audit of medical charts for compliance with HEDIS, · QARR, · Medicare Advantage Star measure specifications.This position will be an integral part of the annual Medical Record Review project required t ...

The Clinical Safety Reviewer / Senior Clinical Safety Reviewer is primarily responsible for reviewing adverse event reports from an assigned project(s), clinical studies and/or post marketing spontaneous reports. · Receives initial and follow-up adverse events (AEs) reports via e ...

+You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. · Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibilit ...

We are seeking a Clinical Quality Reviewer to support the validation and quality review of AI-assisted voice workflows used in care coordination. The role focuses on reviewing voice interactions and transcriptions to ensure accuracy, safety, and alignment with approved clinical p ...

The Clinical Safety Reviewer / Senior Clinical Safety Reviewer is responsible for reviewing adverse event reports from clinical studies and/or post marketing spontaneous reports. · Maintains AE data collection and documentation as per CRF SOP including entering adverse event data ...

The Clinical Review Manager oversees the completion and approval of clinical utilization documentation. They ensure clear visit utilization using evidence-based practices to provide positive clinical outcomes. The manager identifies and addresses inter-professional performance is ...

+ Clinical Review Nurse + · You could be the one who changes everything for our members as a clinical professional on our Medical Management/Health Services team. · + + Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of ca ...

Valene Health is seeking a Clinical Quality Reviewer (RN) to support the validation and quality review of AI-assisted voice workflows used in care coordination. · ...

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team.Clinical Review Nurses analyzes all prior authorization requests to determine medical necessity of service and appropriate level of car ...

We are seeking a Clinical Review Nurse to join our Medical Management/Health Services team. The successful candidate will analyze prior authorization requests to determine medical necessity and appropriate level of care in accordance with national standards and contractual requir ...

You could be the one who changes everything for our members as a clinical professional on our Medical Management/Health Services team. · Clinical Review Nurse must have an active New York State nursing license to analyze prior authorization requests to determine medical necessity ...

You could be the one who changes everything for our members as a clinical professional on our Medical Management/Health Services team. · ...

The primary function of the Clinical Quality Reviewer - Seasonal is to conduct audit of medical charts for compliance with HEDIS, QARR, Medicare Advantage Star measure specifications. · ...

The primary function of the Clinical Quality Reviewer - Seasonal is to conduct audit of medical charts for compliance with HEDIS, QARR, Medicare Advantage Star measure specifications. · ...

As an Authorization Management Clinical Reviewer, you'll play a vital role in ensuring patients receive the right care at the right time. · ...