Care Review Nurse
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
Columbus, OH · On-site
Care Review Nurse Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing ...
Columbus, OH · On-site
Care Review Nurse Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business ...
Columbus, OH · On-site
Care Review Nurse Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business ...
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Columbus, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Columbus, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Columbus, OH · On-site
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Powell, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Powell, OH · On-site +1
Performs and/or assists with credit reviews for quality, accuracy, and compliance with regulations, seeking guidance from senior staff or management when necessary. Conducts independent detailed ...
Columbus, OH · On-site
$40 - $45/hr
De Novo, a boutique staffing and recruitment agency, is currently seeking a personal injury attorney with discovery review experience to work directly with one of our clients. This is a contract to ...
Quick apply
Columbus, OH · On-site
$40 - $45/hr
De Novo, a boutique staffing and recruitment agency, is currently seeking a personal injury attorney with discovery review experience to work directly with one of our clients. This is a contract to ...
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Columbus, OH · On-site
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...
Columbus, OH · On-site
Care Review Clinician Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at ...
Columbus, OH · On-site
Care Review Clinician Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at ...
Columbus, OH · On-site
Care Review Clinician Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
Columbus, OH · On-site
Care Review Clinician Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
Delaware, OH · Remote
$73K - $122K/yr
Conduct reviews, monitoring activities, and audits to identify unusual, suspicious, or potentially non-compliant activity; investigate findings and escalate concerns as appropriate. * Provide ...
Delaware, OH · Remote
$73K - $122K/yr
Conduct reviews, monitoring activities, and audits to identify unusual, suspicious, or potentially non-compliant activity; investigate findings and escalate concerns as appropriate. * Provide ...
Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review * Makes sound, independent decisions based on ...
Reviews medical records/case file, writes a decision that is clear, concise, and impartial and supports the determination made, and documents review * Makes sound, independent decisions based on ...
London, OH · On-site
$60K - $80K/yr
You'll conduct detailed reviews of educational content across formats - including Canvas courses, PDFs, and eBooks - to catch and report errors before they reach learners. You'll also help build and ...
London, OH · On-site
$60K - $80K/yr
You'll conduct detailed reviews of educational content across formats - including Canvas courses, PDFs, and eBooks - to catch and report errors before they reach learners. You'll also help build and ...
Heath, OH · On-site
$71.40 - $96.60/hr
Review test data, direct repairs, develop process improvements, capture process changes, and solve problems brought about with new workloads and part obsolescence. * Collaborate with program ...
New
Heath, OH · On-site
$71.40 - $96.60/hr
Review test data, direct repairs, develop process improvements, capture process changes, and solve problems brought about with new workloads and part obsolescence. * Collaborate with program ...
New
Columbus, OH · On-site
Care Review Processor Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
Columbus, OH · On-site
Care Review Processor Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
Columbus, OH · On-site
Care Review Processor Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
Columbus, OH · On-site
Care Review Processor Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and ...
$93K - $167K/yr
Psychologist Reviewer - ABA Work location - Virtual This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
$93K - $167K/yr
Psychologist Reviewer - ABA Work location - Virtual This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and ...
Be Seen First
Gahanna, OH · On-site
$25 - $45/hr
Driving to construction sites and conducting quality reviews on the day it is scheduled. Work may be started anytime during the day between 8 am to 3:30 pm. Reports are submitted on site ...
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Be Seen First
Gahanna, OH · On-site
$25 - $45/hr
Driving to construction sites and conducting quality reviews on the day it is scheduled. Work may be started anytime during the day between 8 am to 3:30 pm. Reports are submitted on site ...
De Novo, a boutique staffing and recruitment agency is currently seeking a Discovery Review Contract Attorney with experience in the area of personal injury and/or mass tort/class action to work ...
Quick apply
De Novo, a boutique staffing and recruitment agency is currently seeking a Discovery Review Contract Attorney with experience in the area of personal injury and/or mass tort/class action to work ...
$6.25 - $13.46
2% of jobs
$13.46 - $20.67
19% of jobs
$21.50 is the 25th percentile. Wages below this are outliers.
$20.67 - $27.88
36% of jobs
$27.88 - $35.10
14% of jobs
$36.61 is the 75th percentile. Wages above this are outliers.
$35.10 - $42.31
20% of jobs
$42.31 - $49.52
2% of jobs
$49.52 - $56.73
1% of jobs
$56.73 - $63.94
1% of jobs
$63.94 - $71.15
3% of jobs
$71.15 - $78.37
2% of jobs
$78.37 - $85.58
0% of jobs
$6
$35
$85
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Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing Healthcare members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
Medicaid Division
Duties: Review cases for in patients/in hospital: skilled care, acute rehab and long term acute care Nurses working at the facilities Members are being care for, will be sending over clinical information to be reviewed by the Care Review Clinician. Therefore, this agent will not be traveling and will be reviewing information at the office.
Qualifications: Background Hospital Utilization Management. Insurance Utilization Manager/Review and Millemen Experience (MCG). No case managers if that is their only experience. Must have Utilization Review or Management. Utilization Review (1 year +), Past hospital experience (3-4 years of experience, less experience is ok if they have more Utilization Review experience) Potential for longer term dependent on enrollment Workers will be doing Concurrent Inpatient Review MUST have one of the following AT LEAST -Utilization Review in hospital setting Nurses who are used to doing both production and review work
All your information will be kept confidential according to EEO guidelines.
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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.
Recruiting and staffing services
51 - 200 Employees
Edison, NJ, US
1996