1 - 10 of 2,881 Medical Necessity Reviewer jobs

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  • Utilization Review Nurse (RN)

    The Execu|Search Group

    - New York City, NY

    member and/or family to determine medical necessity and benefit eligibility * ... medical necessity criteria to a physician reviewer for consideration, ensuring the...

    10 days ago from Execu-Search
  • RN Patient Adnission Call Center - Flex - All Shifts/Combo of Shifts

    NEW

    UC Health

    - Loveland, CO

    for clinical/unit appropriateness and medical necessity. Takes action in the event criteria are not met or appropriate resources are not available. Provides direction and support...

    1 day ago from UC Health
  • RN Patient Admissions Call Center - Flex - All Shifts/Combo of Shifts

    UC Health

    - Loveland, CO

    for clinical/unit appropriateness and medical necessity. Takes action in the event criteria are not met or appropriate resources are not available. Provides direction and support...

    5 days ago from UC Health
  • Medical Review RN - Per-Diem (Nights)

    NEW

    Mercy Healthcare Sacramento

    - Rancho Cordova, CA

    Accountabilities: 1. Completes medical necessity utilization reviews and documents ... status or continued stay medical necessity criteria. 12. Completes,...

    3 days ago from Mercy Healthcare Sacramento
  • Utilization Review Nurse RN

    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,...

    9 days ago from Novant Health
  • RN Utilization Review

    NEW

    Baylor Scott & White Health

    - Dallas, TX

    criteria for the purpose of evaluating medical necessity for hospitalization, ... plan utilization departments regarding medical necessity for prospective,...

    9 hours ago from Baylor Scott & White Health
  • Social Worker (MSW)-Case Management (FT Days Rotating WE)

    Parkridge Medical Center

    - Chattanooga, TN

    robotic surgery team. The Parkridge Medical Center Emergency Department is an ... criteria for appropriateness of care and medical necessity. * Manages the process to...

    5 days ago from Parkridge Medical Center
  • Appeals Reviewer RN - Case Management Resource Center

    Adventist Health Southern California

    - Glendale, CA

    post discharge, and post serviced medical necessity review to determine ... case to support appeal utilizing appropriate medical necessity criteria. If clinical...

    12 days ago from Adventist Health Southern California
  • Concurrent Review Nurse

    Cameron Craig Group

    - Eugene, OR

    for other determinations • Complete medical necessity and level of care reviews for ... information in various medical management systems Qualifications: - Minimum of...

    13 days ago from Cameron Craig Group
  • Per Diem Nurse Practitioner

    Landmark Health

    - Buffalo, NY

    gathering clinical information for medical necessity determinations for service ... skills Detail oriented; excellent with medical records accuracy and comprehensive...

    12 days ago from Landmark Health
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