Description Providence Queen of the Valley Medical Center is committed to delivering top-notch healthcare, earning recognition from the Association of California Healthcare Districts (ACHD) Award in recognition of our outstanding contribu...

American Traveler is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Fort Myers, Florida. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 10/26/2026 Durat...

Medlivo is seeking a travel nurse RN Utilization Review for a travel nursing job in Portland, Oregon. Job Description & Requirements Specialty: Utilization Review Discipline: RN Duration: 13 weeks 40 hours per week Shift: 8 hours, d...

Food Label Review Specialist Location: Oxnard, CA Schedule: Monday-Friday | 7:00 AM - 3:30 PM Pay Rate: $28.00 - $35.00 per hour Department: Quality & Food Safety / Technical Services About the Role We are seeking a detail-oriented...

required for highly-complex and/or escalated reviews, and providing expert guidance to team members and partnering with the health care... and/or escalated reviews, and providing expert guidance to team members and partnering with the health care team, members...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

performs ongoing credit reviews, validates risk ratings and credit quality, identifies emerging portfolio risks, and provides... Audit, external quality assessments, and other third-party reviews. Lead preparation of clear, complete, and defensible...

product reviews• Manage HACCP, FSMA, GMP, Preventive Controls, and GFSI programs• Review specifications, COAs, and technical...

, and cross-functional stakeholders. Strong investigative skills with experience conducting clinical reviews, quality of care... of CMS, NCQA, Medicare, Medicaid, and other regulatory requirements related to quality of care reviews and investigations...

in line with regulatory and payer requirements. Essential Functions: Conduct clinical reviews of biologic medication..., providers and other healthcare facilities to gather required clinical documentation. Prepare and document clinical reviews...

class is assigned to the Tactical Review and Evaluation Division of the Chicago Police Department and reviews use of force... for improvement; and performs related duties as required. ESSENTIAL DUTIES Reviews documented incidents of use of force, firearm...

assessed, and assuring the development, implementation, and updates to the individualized patient plan of care. Reviews... reviews for all patients. Ensures required visits are completed timely. Reviews plans of care and other paperwork...

Commercial Examiner II independently conducts borrower file reviews within the scope of Examinations and continuous review... Examiner II independently conducts borrower file reviews, in concert with leadership, relative to ongoing Examinations...

: Conduct utilization reviews of patient records to assess medical necessity and appropriateness of care. Collaborate...

to accurately perform drug prior authorization reviews. This position will assist with providing education and acts as a team lead... to make a final decision regarding pre-certification of a medication. Perform reviews for incoming drug prior...

authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance...

referrals. The Clinical Quality Reviewer will conduct comprehensive quality reviews, evaluate clinical concerns, determine... to apply clinical judgment during complex case reviews Behavioral health experience preferred for occasional support needs Preferred...

Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being.... Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member. Reviews...

conducting admission criteria assessments, benefits eligibility reviews, care coordination, concurrent and continued stay reviews... patients. Perform care coordination and utilization reviews including concurrent, continued stay, pre-certification, prior...

Performs concurrent reviews of members for appropriate care and setting to determine overall health and appropriate level... of care Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay...