1 - 10 of 4,971 Medical Necessity Reviewer jobs

  • Utilization Review Registered Nurse

    Novant Health

    - Manassas, VA

    initial, concurrent, and retrospective medical necessity reviews. All Utilization Review activities are performed in accordance with the current policies and procedures, mission,...

    12 days ago from Novant Health
  • Utilization Management/Review RN full time

    Sunbelt Staffing

    - San Antonio, TX

    and inpatient/outpatient treatment plans for medical necessity and efficiency in ... Determines medical necessity of each request by applying appropriate medical criteria to f...

    10 days ago from Sunbelt Staffing
  • Clinical Care Reviewer Utilization Management

    AmeriHealth Caritas

    - Philadelphia, PA

    Reviewer is responsible for completing medical necessity reviews. Using clinical ... necessary to perform a thorough medical necessity review. It is within the nurse’s...

    30+ days ago from AmeriHealth Caritas
  • Director, Medical Necessity Review

    HCA Healthcare

    - Franklin, TN

    responsible for supporting medical necessity program development within the ... potential performance opportunities and/or medical necessity review issues. * Assess...

    9 days ago from HCA Healthcare
  • Nurse Practitioner Needed for Vacation Coverage (4 Months)


    Maxim Facility Nursing

    - Cerritos, CA

    to assist physician in diagnosing medical and surgical problems and prescribing ... and diagnostic procedures; explain necessity, preparation, nature and anticipated...

    5 hours ago from Maxim Facility Nursing
  • Utilization Care Manager - 24hrs


    - Providence, RI

    designee. Conducts surveillance over medical necessity of patient care records. In collaboration with the physician of record and the Utilization Review Committee physician...

    30+ days ago from Lifespan
  • Supv Med/Surg (06437-61530)

    Conroe Regional Medical Center

    - Conroe, TX

    may include but not limited to PEPP, medical necessity, lab compliance, billing, ... implementation of operational standards for Medical-Surgical Unit services which promotes...

    30+ days ago from Conroe Regional Medical Center
  • Staff Nurse (Revenue Utilization Review)

    U.S. Department of Veterans Affairs

    - Las Vegas, NV

    and assistance regarding documentation of medical necessity, insurance review criteria, and SC issues and documents the results of the review in VISTA and Huron and coordinates...

    7 days ago from U.S. Department of Veterans Affairs
  • RN Case Manager Utilization Review

    HCA Healthcare

    - Bountiful, UT

    * Evaluates new ER admissions for medical necessity using approved criteria ... T system, application of the criteria for medical necessity determination and...

    8 days ago from HCA Healthcare
  • PharmacyTechnician Clinical Care Coordinator


    Rph On the Go

    - New York

    call center services. Serves as first line reviewer in monitoring and ensuring adherence ... claims history, clearly defines the medical necessity of non-formulary and prior...

    14 hours ago from RPh on the Go
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