39 Medical Necessity Review jobs in United States

Harrisburg, Pennsylvania, US (Hybrid)

Category: Health Care Location: Harrisburg Pennsylvania United States Seeking a Registered Nurse (RN) – Expert Medical Examination Consultant to…

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$71.2–115.7K / year

The CRN is responsible for performing medical reviews using established criteria to ensure the member is receiving care at the most appropriate level.

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

Florida, US (Hybrid)

$25.00 – $41.00 / hour

The Administrative Nurse, LPN will support Clinical Review/Utilization Management processes in pre-service medical review, post-service medical…

Pennsylvania, US (Hybrid)

$72.7–116.6K / year

Company : Endorsed Job Description : JOB SUMMARY This is a full-time hybrid work from home position requiring travel within the assigned territory.

United States (Remote)

Overview Detailed review, analysis and extraction of clinical information from patient medical records and drafting of effective narratives for…

United States (Remote)

Summary We are currently hiring for an RN Appeals Analyst to join BlueCross BlueShield of South Carolina.

United States (Remote)

Overview HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an…

United States (Remote)

$56.4–90.4K / year

Job Summary: Complex Population Service Determination Specialist II is responsible for processing medical necessity and noncommunity supports and…

United States (Remote)

$65–70K / year

Scope: The Medical Review Specialist is a Registered Nurse who conducts the Utilization Review process by obtaining medical information and…

United States (Remote)

Kingman Healthcare Incorporated (KHI) Staff Position Description Position Title: Utilization Review Nurse Position Code: RN-6027 Department: Case…

United States (Remote)

$40.00 / hour

This position is fully remote, however, you must reside in the State of Texas The position is a contract for about 6 months.

United States (Remote)

$27.00 – $49.00 / hour

Position Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating…

United States (Remote)

$75–88K / year

Why Comagine Health? Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and…

United States (Remote)

JOB SUMMARY: Responsible for clinical review of utilization requests and assessment and implementation of potential coordination of care…

United States (Remote)

$38.00 – $44.00 / hour

Overview Who We Are Because health is personal.

United States (Remote)

$27.00 – $49.00 / hour

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

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)

$63.1–94.7K / year

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