103 Clinical Review jobs in South Carolina, United States

South Carolina, US (Hybrid)

Job Description Summary The Outpatient CDI Specialist is a hybrid role that combines the expertise of clinical documentation improvement (CDI) and…

United States (Remote)

Position Purpose: Analyzes all prior authorization requests to determine medical necessity of service and appropriate level of care in accordance…

United States (Remote)

Overview NAH reserves the right to make hiring decisions based on applicants' state of residence if outside the state of Arizona.

United States (Remote)

$36.00 – $38.00 / hour

Vida is looking for a licensed RN or LPN to manage clinical review requests, escalations, and member inquiries in a fully remote, virtual care setting.

United States (Remote)

$34.00 – $61.00 / hour

Position Purpose: Act as the liaison for all statewide appeals, fair hearings, review organizations, and other external type appeals.

United States (Remote)

$73–125K / year

Job Description A bit about this role: The Clinical Readmission Manager is responsible for conducting prepayment and post-payment clinical reviews of…

United States (Remote)

About the Role We are seeking Registered Nurses with at least 5 years of clinical experience — bedside nursing, case management, clinical nurse…

United States (Remote)

$65K / year

Description MEDvidi is a multi-state telehealth behavioral health organization making high-quality psychiatric care accessible, safe, and consistent.

United States (Remote)

$65–90K / year

Overview: Dane Street is seeking highly motivated candidates to join our team as a Clinical (RN) QA Specialist, specializing in Disability.

United States (Remote)

$150K / year

About Seven Starling Seven Starling is a leading virtual provider of women's behavioral health services supporting every stage of their reproductive health.

United States (Remote)

$70–75K / year

About Us: Our purpose is to help clients exceed their financial health goals.

United States (Remote)

$35.00 / hour

About Hone Hone is an online medical clinic at the forefront of transforming healthcare and enhancing longevity.

United States (Remote)

From $114K / year

Compensation for this role is expected to be approximately $114,000 annually.

United States (Remote)

$82–87K / year

The Clinical Compliance Auditor II is responsible for ensuring Guidehealth’s clinical operations, utilization management activities, and delegated…

United States (Remote)

Overview and responsibilities: Coordinates efforts to obtain and maintain certifications of excellence including Heart Failure and Stroke.

United States (Remote)

Dane Street has embarked on a program where we are looking for Registered Nurses to perform reviews and clinical summaries for disability claims.

United States (Remote)

By joining Sedgwick, you'll be part of something truly meaningful.

United States (Remote)

$35.00 – $40.00 / hour

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw…

United States (Remote)

$78–88K / year

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges.

United States (Remote)

$82.7–96.5K / year

Job Description A bit about this role: The Clinical Guide Part A will be part of the Utilization Management team, responsible for inpatient,…