1 week ago Be among the first 25 applicants Job Title:Clinical Review Nurse (RN) – Utilization Management Location:Oregon or bordering states Duration:3+ Months Job Summary: This role uses clinical expertise to review medical records for medical appropriateness based on established criteria and contractual guidelines. The nurse will ensure timely, accurate case handling and serve as a key liaison between providers and internal departments. Key Responsibilities: Conduct medical record reviews in accordance with clinical and contractual standards Prioritize and manage daily case queues to meet workload demands Collaborate with supervisors on quality assurance and continuous improvement Maintain up-to-date knowledge of review processes and clinical best practices Serve as a liaison for provider communications and issue resolution Build and maintain positive relationships with internal and external stakeholders Participate in required training and meetings for updates and compliance Crosstrain to support broader team needs and ensure workforce flexibility Comply with HIPAA and all corporate privacy and security policies Required Qualifications: Willingness or ability to be licensed in Nebraska if not compact-eligible Bachelor’s degree in a healthcare-related field At least 2 years of experience in Utilization Management or Clinical Review Preferred Qualifications:
...personnel qualifications set forth by the Michigan Department of Lifelong Education, Advancement, and Potential (MiLEAP) Licensing Rules for Child Care Centers. A Bachelors Degree in Early Childhood Education; a Bachelors Degree in Birth to Kindergarten Education; or...
...Individuals who are committed to exceptional customer service, detail oriented, with a willingness to go above and beyond.Featured on TIME, CNN, NPR, and Travel Channel, 85C Bakery Cafe has become a culinary phenomenon and a new cafe experience for all. Founded in 2004, 85C...
...Salary $80-100 Location New York, USA Type Contract Start ASAP NetSuite Consultant 230268 Desired skills: NetSuite, ERP, NetSuite Administrator , NetSuite Consultant NetSuite ERP Consultant (Techno-Functional | Inventory...
...Manufacturing, and Waste management space. We design and manufacture sensors for storage tanks... ...own.Job DescriptionAssists the lead developer and or developers in composing the load... ...and supports high volume batch file and web service integrationsDesign cutting-edge...
...innovative organization and the opportunity to learn and grow professionally? We can help! We are seeking a qualified CDL Class A Fuel Tanker Driver to operate a fuel tanker truck in support of ground operations and camp support activities in Yuma, Arizona. The driver will...