Clinical Care Reviewer UM Job Summary The primary purpose of the job is to: Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity ...
Clinical Care Reviewer UM Job Summary The primary purpose of the job is to: Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity ...
Medical Record Reviewer
Fort Wayne, IN · On-site
Medical Record Reviewer Community Home Health Care is hiring an in-office QA Nurse to oversee the accuracy, completeness, and regulatory compliance of all clinical documentation. This role is ...
Medical Record Reviewer
Fort Wayne, IN · On-site
Medical Record Reviewer Community Home Health Care is hiring an in-office QA Nurse to oversee the accuracy, completeness, and regulatory compliance of all clinical documentation. This role is ...
Clinical Care Reviewer
Harrisburg, PA · On-site
Reviews inpatient and outpatient services requiring Plan approval; reviews may be pre-service, concurrent or retrospective in nature. Assesses and appropriately channels/facilitates discharge ...
Clinical Care Reviewer
Harrisburg, PA · On-site
Reviews inpatient and outpatient services requiring Plan approval; reviews may be pre-service, concurrent or retrospective in nature. Assesses and appropriately channels/facilitates discharge ...
Clinical Care Reviewer
Philadelphia, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Clinical Care Reviewer
Philadelphia, PA · On-site
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Appraisal Reviewer
Hauppauge, NY · On-site
$66K/yr
Review all appraisals to determine compliance with basic principles of appraisal practice has been observed. * Review all appraisals to determine whether all necessary documentation and information ...
Appraisal Reviewer
Hauppauge, NY · On-site
$66K/yr
Review all appraisals to determine compliance with basic principles of appraisal practice has been observed. * Review all appraisals to determine whether all necessary documentation and information ...
Clinical Accreditation Reviewer
Washington, DC · On-site
$120K - $135K/yr
The Accreditation Reviewer is an expert in the content and interpretation of accreditation programs and standards. Primary responsibilities include analyzing accreditation application documentation ...
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Clinical Accreditation Reviewer
Washington, DC · On-site
$120K - $135K/yr
The Accreditation Reviewer is an expert in the content and interpretation of accreditation programs and standards. Primary responsibilities include analyzing accreditation application documentation ...
Clinical Reviewer Nurse
Miramar, FL · On-site
By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won't receive unnecessary procedures, ineffective treatment, or unnecessarily extensive ...
Clinical Reviewer Nurse
Miramar, FL · On-site
By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won't receive unnecessary procedures, ineffective treatment, or unnecessarily extensive ...
Data Reviewer, Quality Control
Verona, WI · On-site
Data Reviewer The Data Reviewer is responsible for ensuring the completion, quality, and compliance of laboratory data and reports produced within the Quality Control (QC) team. This includes the ...
Data Reviewer, Quality Control
Verona, WI · On-site
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RN OASIS Reviewer
Brooklyn, NY · On-site
$90K - $95K/yr
RN OASIS Reviewer The RN OASIS Reviewer is responsible for reviewing and coding clinical documentation. Qualifications: · Current New York State license to practice as a Registered Nurse. · Working ...
RN OASIS Reviewer
Brooklyn, NY · On-site
$90K - $95K/yr
RN OASIS Reviewer The RN OASIS Reviewer is responsible for reviewing and coding clinical documentation. Qualifications: · Current New York State license to practice as a Registered Nurse. · Working ...
Nurse Reviewer - Reading, PA
Reading, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Nurse Reviewer - Reading, PA
Reading, PA · Remote
$40/hr
Nurse Reviewer PT (20-30 hours week) - Remote Work Environment Non-Exempt: $40.00 hour Supports Medical Review Services. The Nurse Reviewer plays a critical role in supporting the Medical Review ...
Greenlife Healthcare Staffing is seeking an experienced Maternal Nurse Reviewer to conduct clinical reviews and program monitoring for a respected non-profit organization. The ideal candidate will ...
Greenlife Healthcare Staffing is seeking an experienced Maternal Nurse Reviewer to conduct clinical reviews and program monitoring for a respected non-profit organization. The ideal candidate will ...
By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won't receive unnecessary procedures, ineffective treatment, or unnecessarily extensive ...
By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won't receive unnecessary procedures, ineffective treatment, or unnecessarily extensive ...
Physician Reviewer
Manhattan, NY · On-site
We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in ...
Physician Reviewer
Manhattan, NY · On-site
We are seeking a highly experienced DRG Clinical Physician Reviewer to join our growing clinical review team. This is a fully remote opportunity for a physician with a strong background in ...
Data Reviewer Located at our large molecule headquarters in Research Triangle Park (RTP), North Carolina, the Data Reviewer position will be in the AC team supporting analytical activities related to ...
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Appraisal Reviewer
San Antonio, TX · On-site
$60K - $70K/yr
Review appraisal reports for accuracy, completeness, and compliance with appraisal industry standards. * Analyze comparable sales selection, adjustments, valuation methodology, and market commentary ...
Appraisal Reviewer
San Antonio, TX · On-site
$60K - $70K/yr
Review appraisal reports for accuracy, completeness, and compliance with appraisal industry standards. * Analyze comparable sales selection, adjustments, valuation methodology, and market commentary ...
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews ...
Flex-Schedule Occupancy Review Reviewer
Salida, CO · On-site
$25 - $35/hr
Ad Ref: FAR-00257 Do not fill out any form or use any other apply button on this page. Use the blue link below to submit your application. Apply HERE Only FAR Inspections is actively seeking a ...
Flex-Schedule Occupancy Review Reviewer
Salida, CO · On-site
$25 - $35/hr
Ad Ref: FAR-00257 Do not fill out any form or use any other apply button on this page. Use the blue link below to submit your application. Apply HERE Only FAR Inspections is actively seeking a ...
Freelance Medical Reviewer, MyHealthTeam
$20 - $75/hr
Never review a subject or article you feel uncomfortable with The pay range for this role is: 20 - 75 USD per hour (Remote (United States)
Freelance Medical Reviewer, MyHealthTeam
$20 - $75/hr
Never review a subject or article you feel uncomfortable with The pay range for this role is: 20 - 75 USD per hour (Remote (United States)
UM Clinical Reviewer
Coconut Creek, FL · On-site
The Utilization Management Clinical Reviewer works within a multidisciplinary team to help identify and manage members who are in need of additional care or support in their home to improve their ...
UM Clinical Reviewer
Coconut Creek, FL · On-site
The Utilization Management Clinical Reviewer works within a multidisciplinary team to help identify and manage members who are in need of additional care or support in their home to improve their ...
Document Reviewer
$28/hr
Document Reviewer KLDiscovery, one of the largest national eDiscovery providers, is currently seeking attorneys who are actively licensed in any U.S. jurisdiction and desire an engaging work ...
Document Reviewer
$28/hr
Document Reviewer KLDiscovery, one of the largest national eDiscovery providers, is currently seeking attorneys who are actively licensed in any U.S. jurisdiction and desire an engaging work ...
Reviewer information
See salary details
$10.58 - $14.03
1% of jobs
$14.03 - $17.48
13% of jobs
$17.48 - $20.94
4% of jobs
$22.31 is the 25th percentile. Wages below this are outliers.
$20.94 - $24.39
18% of jobs
$24.39 - $27.84
14% of jobs
The median wage is $27.95 / hr.
$27.84 - $31.29
17% of jobs
$31.29 - $34.75
7% of jobs
$35.14 is the 75th percentile. Wages above this are outliers.
$34.75 - $38.20
12% of jobs
$38.20 - $41.65
8% of jobs
$41.65 - $45.10
5% of jobs
$45.10 - $48.56
1% of jobs
$10
$29
$48
How much do reviewer jobs pay per hour?
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How do Reviewers typically collaborate with other team members during the evaluation process?
What is the difference between Reviewer vs Quality Control Inspector?
| Aspect | Reviewer | Quality Control Inspector |
|---|---|---|
| Credentials | Typically requires a degree or certification in the relevant field | Often requires technical training or certification in inspection methods |
| Work Environment | Office or remote review settings, analyzing documents or data | Manufacturing, construction, or production sites inspecting products |
| Employer & Industry | Publishing, media, manufacturing, or software companies | Manufacturing, construction, aerospace, or automotive industries |
| Search & Comparison Intent | Understanding review roles, responsibilities, and qualifications | Comparing inspection and quality assurance roles in industry |
While both reviewers and quality control inspectors ensure standards are met, reviewers primarily evaluate documents, data, or content in office settings, focusing on accuracy and compliance. Quality control inspectors physically examine products or processes on-site to identify defects or issues. Their roles overlap in quality assurance but differ in work environment and specific tasks.
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Job description
Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Clinical Care Reviewer UM
Job Summary
The primary purpose of the job is to:
Under the direction of the unit Supervisor, the Clinical Care Reviewer is responsible for completing medical necessity reviews. Using clinical knowledge and nursing experience, the nurse reviews provider requests for inpatient and outpatient services, working closely with members and providers to collect all information necessary to perform a thorough medical necessity review. It is within the nurse's discretion to pend requests for additional information and/or request clarification. The nurse will use his/her professional judgment to evaluate the request to ensure that appropriate services are approved and recognize care coordination opportunities and refer those cases as needed. The nurse will apply medical health benefit policy and medical management guidelines to authorize services and appropriately identify and refer requests to the Medical Director when guidelines are not met. The nurse will maintain current knowledge and understanding of the laws, regulations, and policies that pertain to the organizational unit's business and uses clinical judgment in their application.
Complete Description: 3 or more years experience in a related clinical setting.
Case management and utilization review experience preferred
Registered Nurse
Excellent oral and written communication skills.
Ability to identify problems and recommend solutions.
Self-directed/Ability to work independently.
Excellent decision making skills.
Excellent time management skills, prioritizing work and meeting timelines.
Ability to advocate for member/member family needs.
Dedicated to meeting the expectations and requirements of internal and external customers.
Obtains continuing education required to maintain professional licensure.
Ability to achieve required performance results on all audits and Inter Rater Reliability (Peer to Peer).
Riya Khem
Life Science Recruiter
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I
DIRECT # - 732 -844-8721 | (W) # 732-549-2030 - Ext - 311 |(F) 732-549-5549
About Integrated Resources
Sourced by ZipRecruiter
Integrated Resources Inc (IRI), based in Edison, NJ, US, is an esteemed player in the staffing solutions industry with a credible presence on their official website irionline.com. Notably, IRI provides a range of professional staffing services including contract, contract-to-hire, and direct hire solutions to a wide spectrum of industries such as healthcare, life sciences, manufacturing, financial, insurance, and others. Since its inception, IRI has been committed to delivering top-talent and optimum solutions to meet its clients' diverse needs.
Industry
Recruiting and staffing services
Company size
51 - 200 Employees
Headquarters location
Edison, NJ, US
Year founded
1996