Clinical Review Nurse
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
Lake Mary, FL ยท On-site
Responsibilities * Perform initial clinical reviews and provide documented recommendations based on the use of appropriate clinical guidelines * Review the initial evaluation and clinical ...
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience * 2 years of experience in clinical field of practice, health insurance, or other health care related field Required Education
Washington, DC ยท On-site
$87K/yr
Supervise initial clinical reviews and provide documented recommendations based on appropriate clinical guidelines * Review and approve initial evaluations and clinical documentation against clinical ...
Washington, DC ยท On-site
$87K/yr
Supervise initial clinical reviews and provide documented recommendations based on appropriate clinical guidelines * Review and approve initial evaluations and clinical documentation against clinical ...
Washington, DC ยท On-site
$87K/yr
Supervise initial clinical reviews and provide documented recommendations based on appropriate clinical guidelines * Review and approve initial evaluations and clinical documentation against clinical ...
Washington, DC ยท On-site
$87K/yr
Supervise initial clinical reviews and provide documented recommendations based on appropriate clinical guidelines * Review and approve initial evaluations and clinical documentation against clinical ...
Completes initial review for medical necessity for all admissions in assigned area(s), applying ... Send corresponding initial clinical and H&P's to commercial companies, managed Medicare, VA, and SC ...
Completes initial review for medical necessity for all admissions in assigned area(s), applying ... Send corresponding initial clinical and H&P's to commercial companies, managed Medicare, VA, and SC ...
Completes initial review for medical necessity for all admissions in assigned area(s), applying ... Send corresponding initial clinical and H&P's to commercial companies, managed Medicare, VA, and SC ...
Completes initial review for medical necessity for all admissions in assigned area(s), applying ... Send corresponding initial clinical and H&P's to commercial companies, managed Medicare, VA, and SC ...
Reno, NV ยท On-site
Job Summary The Utilization Review (UR) Nurse (initial clinical reviewer) is a registered nurse (RN) or health professional (licensed practical nurse (LPN) or licensed vocational nurse (LVN)), who ...
Reno, NV ยท On-site
Job Summary The Utilization Review (UR) Nurse (initial clinical reviewer) is a registered nurse (RN) or health professional (licensed practical nurse (LPN) or licensed vocational nurse (LVN)), who ...
Yakima, WA ยท On-site
$22.31 - $33.47/hr
Clinical Review Specialist duties may include ... Verifies initial insurance coverage for each client admitted to an evaluation and treatment ...
Yakima, WA ยท On-site
$22.31 - $33.47/hr
Clinical Review Specialist duties may include ... Verifies initial insurance coverage for each client admitted to an evaluation and treatment ...
Yakima, WA ยท On-site
$22.31 - $33.47/hr
Clinical Review Specialist duties may include ... Verifies initial insurance coverage for each client admitted to an evaluation and treatment ...
Yakima, WA ยท On-site
$22.31 - $33.47/hr
Clinical Review Specialist duties may include ... Verifies initial insurance coverage for each client admitted to an evaluation and treatment ...
As well as, aids and acts as a resource to Initial Clinical Reviewers. What You Will Be Doing: * Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable ...
As well as, aids and acts as a resource to Initial Clinical Reviewers. What You Will Be Doing: * Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable ...
Conduct initial clinical review, concurrent review, and retrospective review. Utilize subject matter expertise, critical thinking, and clinical knowledge to make independent decisions and ...
Conduct initial clinical review, concurrent review, and retrospective review. Utilize subject matter expertise, critical thinking, and clinical knowledge to make independent decisions and ...
As well as, aids and acts as a resource to Initial Clinical Reviewers. What You Will Be Doing: * Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable ...
As well as, aids and acts as a resource to Initial Clinical Reviewers. What You Will Be Doing: * Serve as the specialty match reviewer in Cardiology cases, that do not initially meet the applicable ...
Washington, DC ยท On-site
Apply clinical review criteria, organizational policies, guidelines, and screens to determine the ... initial and continued stay reviews using ASAM, InterQual and or other organization policy ...
Washington, DC ยท On-site
Apply clinical review criteria, organizational policies, guidelines, and screens to determine the ... initial and continued stay reviews using ASAM, InterQual and or other organization policy ...
Review all cases in which clinical determinations cannot be made by Initial Clinical Reviewers, ensuring appropriate use of evidence-based cardiology guidelines and regulatory standards. * Provide ...
Review all cases in which clinical determinations cannot be made by Initial Clinical Reviewers, ensuring appropriate use of evidence-based cardiology guidelines and regulatory standards. * Provide ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
Conducts initial medical necessity clinical screening for simple and routine review cases. * Determines if initial clinical information presented meets medical necessity criteria or requires ...
$15.63 - $20.54
0% of jobs
$20.54 - $25.46
2% of jobs
$25.46 - $30.38
6% of jobs
$30.38 - $35.29
12% of jobs
$36.60 is the 25th percentile. Wages below this are outliers.
$35.29 - $40.21
17% of jobs
The median wage is $43.54 / hr.
$40.21 - $45.13
18% of jobs
$45.13 - $50.04
17% of jobs
$50.76 is the 75th percentile. Wages above this are outliers.
$50.04 - $54.96
13% of jobs
$54.96 - $59.88
8% of jobs
$59.88 - $64.79
4% of jobs
$64.79 - $69.71
2% of jobs
$15
$43
$69
For Slp Initial Clinical Review jobs, the most frequently searched job titles are:

Lake Mary, FL โข On-site
Full-time
Re-posted 6 days ago
TurningPoint Healthcare Solutions is a rapidly growing and innovative healthcare company that supports several large national health plans to improve the quality and affordability of healthcare patients receive. We are looking for motivated individuals who want to be part of our mission and join our team!
As a Utilization Review Nurse, you will utilize your critical thinking skills, clinical expertise and judgement along with established medical criteria to perform first level clinical review for select procedures that require medical necessity authorization. We are seeking individuals who enjoy a challenge, have an ability to work independently and are capable of meeting deadlines. Previous utilization management experience is preferred. In addition to prior experience, the ideal candidate will have an extreme attention to detail, an ability to flourish in a fast-paced environment and advanced grammar, punctuation, and computer skills.
Responsibilities
Qualifications:
Sourced by ZipRecruiter
Health care and social assistance
51 - 200 Employees
Lake Mary, FL, US
2014