Slate Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Camden, Maine. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 11/09/2026 Duration: 8 weeks 40 hour...

HCS 247 is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Arcata, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: 13 weeks 40...

ownership of a case management program(s) pre- authorization reviews to provide Medically Necessary timely and quality health... care services in the most cost-effective manner and pharmacy reviews per population served.We recruit retain and advance...

About this Job: General Summary of Position Responsible for evaluating the necessity appropriateness and efficiency of the use of medical services procedures and facilities. Responsible for clinical review of all acute services for appropr...

Social Worker - Clinical Review Team Lead Setting: Healthcare Facilities Job Type: Contract - Full Time Pay: $32 / Hour Hours: 39.00 Location: Augusta, ME The Social Worker - Clinical Review Team Lead collaborates with the multi...

. Collaborate on training for Operations staff on findings of reviews and audits. Perform other duties as assigned...

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...

reviews to support the timely and accurate processing of member and provider appeals. This role evaluates medical records... required. (Not encumbered only) Key Responsibilities Conduct comprehensive clinical reviews of medical records and supporting...

**Warehouse/Shipping/Production Opportunities!** You will assist in the distribution and shipping operations of home goods products. Fast Scheduling - When you apply with Marathon, you could be working in a few days (depending on curren...

ownership of a case management program(s) pre- authorization reviews to provide Medically Necessary timely and quality health... care services in the most cost-effective manner and pharmacy reviews per population served.We recruit retain and advance...

review and permitting process. This includes facilitating interdepartmental and multi-agency reviews; interpreting...

pharmaceuticals. This role involves performing quality compliance reviews of cGMP analytical data and results from the QC Microbiology.... Responsibilities Provide quality assurance reviews of laboratory raw data and reports, including environmental monitoring...

in office. WORKERS COMP AND EXPERIENCE WITH PEER REVIEWS, LIABILITY MEDICAL ANALYSIS, AND DESIGNATED DOCTORS EXAMS... a vital role in processing referrals within our system for Peer Reviews, Required Medical Exams, Designated Doctors Exams...

, internal reviews, risk-based monitoring, and corrective action activities for a large-scale government assistance program... developing or implementing risk-based monitoring frameworks. Experience conducting internal audits and compliance reviews...

actions to improve right-first-time performance and laboratory compliance. Support periodic record reviews, inspection...

and recommend risk-based actions to improve right-first-time performance and laboratory compliance. Support periodic record reviews...

Overview: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being.... Responsibilities: Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate...

. Research, innovate and propose metrics, analyses, tools or process changes to improve operation. Reviews and ensures...

, families, and healthcare providers. This role requires experienced nursing professionals to perform thorough case reviews.... Responsibilities: Conduct utilization reviews to assess the necessity, appropriateness, and efficiency of healthcare services...

include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA... Quality Department. Key Responsibilities: Conduct thorough medical record reviews using proprietary tools and software...