Talent.com
Tennessee Licensed Senior Medical Reviewer
Tennessee Licensed Senior Medical ReviewerVirtualVocations • Hialeah, Florida, United States
No longer accepting applications
Tennessee Licensed Senior Medical Reviewer

Tennessee Licensed Senior Medical Reviewer

VirtualVocations • Hialeah, Florida, United States
21 days ago
Job type
  • Full-time
Job description

A company is looking for a Registered Nurse Senior Medical Reviewer (Home Health and Hospice).

Key Responsibilities

Acts as team leader for medical review and case management, providing guidance and training to staff

Monitors workflow and workloads, ensuring timely completion of tasks and addressing any issues

Participates in quality reviews and compliance initiatives, ensuring adherence to quality plans

Required Qualifications, Training, and Education

Active, unrestricted RN licensure in the state of hire or compact multistate RN license

Associate Degree in Nursing or graduation from an accredited school of nursing

Four years of clinical experience or a combination of clinical and medical review experience totaling four years

Working knowledge of managed care and healthcare delivery systems

Proficiency in Microsoft Office software

Create a job alert for this search

Medical Reviewer • Hialeah, Florida, United States

Related jobs
Tennessee Licensed Utilization Review Clinician

Tennessee Licensed Utilization Review Clinician

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluate member's treatment for mental health and substance abuse to ensure medical appropriatenes...Show more
Last updated: 4 days ago • Promoted
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Hialeah, Florida, United States
Full-time
A company is looking for a Utilization Review Clinician - ABA.Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services to ensure medica...Show more
Last updated: 30+ days ago • Promoted
New York Licensed Behavioral Medical Director

New York Licensed Behavioral Medical Director

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for a Behavioral Medical Director - Remote.Key Responsibilities Oversee and guide the Utilization Management team, ensuring cost-effective quality care Implement Level of Ca...Show more
Last updated: 30+ days ago • Promoted
Ohio Licensed Utilization Management RN

Ohio Licensed Utilization Management RN

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for a Utilization Management RN Reviewer.Key Responsibilities Conduct admission, concurrent, and retrospective reviews of patient charts and clinical systems Collaborate wit...Show more
Last updated: 3 days ago • Promoted
Maryland Licensed Tumor Registrar

Maryland Licensed Tumor Registrar

VirtualVocations • Miami, Florida, United States
Full-time
A company is looking for a Tumor Registrar, PT Day Shift, Cancer Unit.Key Responsibilities Perform detailed case abstraction of patient data into the oncology database Conduct case finding activ...Show more
Last updated: 14 hours ago • Promoted • New!
Medical Director

Medical Director

Sanitas Medical Center • Fort Lauderdale, FL, United States
Full-time
Medical Director – Plantation, Florida.Sanitas Medical Center | Full-Time | Outpatient Primary Care.Sanitas is a global healthcare organization dedicated to transforming the primary care experience...Show more
Last updated: 4 hours ago • Promoted • New!
State Licensed Senior Medical Director

State Licensed Senior Medical Director

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for a Senior Medical Director of Geriatric Psychiatry Services.Key Responsibilities Lead and oversee psychiatric teams providing telehealth care to older adults with serious ...Show more
Last updated: 30+ days ago • Promoted
Tennessee RN Utilization Review

Tennessee RN Utilization Review

VirtualVocations • Boca Raton, Florida, United States
Full-time
A company is looking for an RN Utilization Review.Key Responsibilities Perform clinical assessments and evaluate injured employees' treatment utilization and compliance Collaborate with healthca...Show more
Last updated: 3 days ago • Promoted
Remote Medical Coding Reviewer

Remote Medical Coding Reviewer

VirtualVocations • Boca Raton, Florida, United States
Remote
Full-time
A company is looking for a Medical Coding Reviewer (DRG).Key Responsibilities Perform clinical and coding medical claim reviews to ensure compliance with coding practices Analyze provider billin...Show more
Last updated: 30+ days ago • Promoted
Infectious Disease

Infectious Disease

Curare Group, Inc. • MIAMI BEACH, Florida, US
Full-time
Infectious Disease physician job in Florida : Unique Concierge medicine opportunity in Miami Beach, Florida.Join a growing group in a position that allows you to focus on quality patient care free ...Show more
Last updated: 30+ days ago • Promoted
Texas Licensed Physician Reviewer

Texas Licensed Physician Reviewer

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for Board Certified Physician Reviewers in Internal Medicine / Allergy & Immunology with a Texas license. Key Responsibilities Review treatment requests and appeals for medical ...Show more
Last updated: 18 hours ago • Promoted • New!
Texas Licensed Clinical Auditor

Texas Licensed Clinical Auditor

VirtualVocations • Miami, Florida, United States
Full-time
A company is looking for a Clinical Review Auditor.Key Responsibilities Review medical records to determine accuracy of billing through verification of coding and supporting documentation Conduc...Show more
Last updated: 3 days ago • Promoted
Arizona Licensed Medical Director

Arizona Licensed Medical Director

VirtualVocations • Miami, Florida, United States
Full-time
A company is looking for a Medical Director responsible for overseeing medical staff services and ensuring compliance with healthcare regulations. Key Responsibilities Provide medical oversight an...Show more
Last updated: 30+ days ago • Promoted
Travel CT Tech - $1774 / Week

Travel CT Tech - $1774 / Week

Fusion Medical Staffing • Margate, FL, US
Full-time
Fusion Medical Staffing is seeking an experienced CT Tech for an exciting Travel Allied job in Margate, FL.Shift : Inquire Start Date : ASAP Duration : 13 weeks Pay : $1774 / Week.Fusion Medical Staffi...Show more
Last updated: 13 days ago • Promoted
State Licensed Medical Director

State Licensed Medical Director

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for a Clinical Review Medical Director specializing in Cardiology or Neurology, with remote work options available. Key Responsibilities Conduct coverage reviews based on memb...Show more
Last updated: 30+ days ago • Promoted
Medical Director - Arizona Licensed

Medical Director - Arizona Licensed

VirtualVocations • Fort Lauderdale, Florida, United States
Full-time
A company is looking for a Clinical Review Medical Director - Internist, Surgery or Plastic Surgery - Remote.Key Responsibilities Conduct coverage reviews based on individual member plan benefits...Show more
Last updated: 30+ days ago • Promoted
Texas Licensed Concurrent Review RN

Texas Licensed Concurrent Review RN

VirtualVocations • Miami, Florida, United States
Full-time
A company is looking for an RN Concurrent Review.Key Responsibilities Monitor and document medical treatment telephonically, ensuring compliance with established guidelines Track patient progres...Show more
Last updated: 3 days ago • Promoted
Multi-State Licensed Care Review Clinician

Multi-State Licensed Care Review Clinician

VirtualVocations • Boca Raton, Florida, United States
Full-time
A company is looking for a Care Review Clinician (LVN / LPN).Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze clinical service ...Show more
Last updated: 3 days ago • Promoted