Clinical reviewer jobs in Bayonne, New Jersey - Page 4Crear alertas

Clinical Quality Reviewer - Hybrid. Clinical Quality Reviewer – Seasonal. Perform clinical audits via EMR, in-house paper records, and on-site provider visits to collect documentation of measure compliance.

Paying $63 an hour Position Overview: The primary function of the Clinical Quality Reviewer - Seasonal is to conduct audit of medical charts for compliance with HEDIS, QARR, Medicare Advantage Star measure specifications. TOP HEALTH INSURANCE COMPANY NOW HIRING CLINICAL QUALITY REVIEWER Located in

Clinical background: Health Educator, LPN, RN, LMSW, or LCSW Minimum 2 years of HEDIS review experience in a managed care or health plan setting Experience with medical record review for HEDIS/QARR measures Licensure/Certification Required: Health Educator, LPN, RN, LMSW, or LCSW with ≥2 years HED

Anesthesia physician job in New Jersey : Red Bank embodies the best of all worlds with fine arts and galleries, world-class shopping, gourmet and casual dining, premier real estate properties both residential and commercial, theaters and performing arts, diverse cultures, and magnificent natural res

Clinical Quality Reviewer - Hybrid.

This role ensures accurate coding and clinical support for DRG assignments, helping improve billing accuracy, reimbursement, and compliance. Review medical records to validate DRG assignments and ensure clinical documentation supports coding decisions. Confirm that physician notes and clinical indic

Review non-qualified assessments with the Clinical Quality Assurance Department. Minimum 2 years clinical experience required with RN license.

Collect and scan to file all pertinent documentation to support a complete Clinical Assessment. Review all aspects of clinical assessment and supporting documentation to make determination of participant's functional capacity outcome with justification or recommendations for further physician review

Freelance Medical Reviewers Needed. We're working toward a future where social support is prescribed alongside clinical care. MyHealthTeam is looking for freelance medical reviewers who will assess and improve the medical accuracy of our content.

Job Title: Physician Reviewer: Utilization Management (Contract-to-Hire) Location: Remote (Must reside in IL, MT, NM, OK, TN, or TX) Employment Type: Contract-to-Hire (C2H) Schedule: Monday–Friday, 8:00 AM – 5:00 PM CST (Occasional weekend coverage ~3–4 days/year) Position Overview Our client

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. We partner with highly qualified, actively practicing physicians to ensure high-

Rowe Price, we identify and actively invest in opportunities to help people thrive in an evolving world.As a premier global asset management organization with more than 85 years of experience, we provide investment solutions and a broad range of equity, fixed income, and multi-asset capabilities to

We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system. Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Review

Rowe Price, we identify and actively invest in opportunities to help people thrive in an evolving world.As a premier global asset management organization with more than 85 years of experience, we provide investment solutions and a broad range of equity, fixed income, and multi-asset capabilities to

When needed, obtain current information on each patient's clinical progress from various sources and present complete and appropriate clinical information to managed care companies.

Medical Bill Review II, Support.US-TX-Dallas | US-NJ-Jersey City | US-GA-Alpharetta.The Medical Bill Review Support Analyst supports the Medical Management department's key goals of enhancing cost containment.Provides strategic and technical bill review to assist claim offices and adjusters.Accompli

An Epic Medical Analyst (also known as an Epic Analyst or Epic Clinical Analyst) is responsible for implementing, optimizing, maintaining, and supporting Epic Electronic Health Record (EHR) systems. This role focuses on enhancing clinical workflows, improving system performance, and supporting healt

Registered Nurse / MDS Coordinator - New York, NY (3191).About Greenlife Healthcare Staffing:.Greenlife Healthcare Staffing is a leading nationwide recruitment agency dedicated to connecting healthcare professionals with top-tier opportunities.We partner with hospitals, clinics, nursing homes, mul

At Fitch, we have an open culture where employees are able to exchange ideas and perspectives, throughout the organization, irrespective of their seniority.Your voice will be heard allowing you to have a real impact.We embrace diversity and appreciate authenticity encouraging an environment where em

ACS borough office as the lead clinical consultant on early childhood development issues impacting families known to child welfare. Complete required documentation of clinical consults, using ACS templates, within the requisite time frames. In conjunction with the Team Coordinator and other consulta

We partner with primary care providers to improve the engagement and management of their Medicaid patients, offering independent practices with specialized resources and clinical programs to close gaps in care. We are looking for someone who has excellent communication skills, and the ability to com

The Review Physician works in close collaboration with Clinical Services Department staff and is responsible for review of all applicable Clinical Assessment, Clinical Re-assessment, and additional assessment services when indicated. FCO cannot be determined on the basis of the Clinical Assessment o

Northern Manhattan Rehabilitation & Nursing Center is a diverse and dynamic STR/LTC facility committed to service excellence and outstanding resident and patient outcomes, located in the heart of Manhattan.Only steps from train and bus stations, Northern Manhattan Rehabilitation & Nursing Center is

Job Title: Clinical Research Coordinator Job Description The Clinical Research Coordinator plays a pivotal role in the execution of clinical trials by utilizing Good Clinical Practices (GCP) to screen, enroll, and monitor study subjects while ensuring compliance with protocols and regulations. Mai

Candidates should bring at least two years of clinical experience, ideally in home health care or within a health plan. Your clinical expertise will guide you in reviewing care plans, providing essential self-care training, and ensuring Members have access to valuable resources. You'll document asse

Performs and manages all types of audits in the audit program of Clinical Development and Safety Pharmacovigilance. CROs, CMOs, investigator sites, and clinical vendors.

Job Title : HEDIS Quality Reviewer Location : New York, NY 10004 Duration : 2 + Months Contract Education : High School/GED with a minimum of two years HEDIS review experience Shift Details : 9:00 AM -5:00 PM Job Description: The position will be responsible for processing incoming medical charts vi

Are you ready to give back to the community while pursuing your passion? For over 50 years, Acacia Network and its affiliates have been committed to improving the quality-of-life and wellbeing of underserved communities in New York City and beyond.We are one of the leading human services organizatio

This full-time faculty position is based in Manhattan and offers the opportunity to lead and expand NYU's rapidly growing portfolio of clinical trials in diabetes, obesity, and related metabolic diseases. Key Responsibilities Design, lead, and implement clinical trials focused on Type 1 and Type 2 d

Datavant is a data platform company and the world's leader in health data exchange.Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format.Our platform is powered by the largest, most diverse health data network in the U.Datavant is trusted b

Rothschild & Co is a leading global financial services group with seven generations of family control and a history of over 200 years at the centre of the world's financial markets.Our expertise, intellectual capital and global network enable us to provide a distinct perspective that makes a meaning

Brooklyn Clinical Research was founded to increase access to clinical trials for underrepresented communities. Clinical-trial enrollment should accurately represent the broader population. The PI will oversee clinical trials primarily in Phase 2 and Phase 3, focusing on high-impact therapeutic areas

Top Healthcare Provider Network The 61st Street Service Corporation, provides administrative and clinical support staff for ColumbiaDoctors.

Role: Clinical Coding Auditor & Trainer. Location: Remote, NY, US (The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Willingness to travel to New York twice a year RN, PA, MD, APRN, DO, or MBBS license Valid/Current CPC or CIC Cert

Mount Sinai - Icahn Building (1425 Madison) [Medical Office Assistant] As a Flex Staff at Mount Sinai, you'll: Provide patient care and support in various departments; Assist in administrative tasks and maintain records; Conduct routine medical tests and report findings; Collaborate with healthcare

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. We partner with highly qualified, actively practicing physicians to ensure high-

The Office of Labor Relations (OLR) represents the Mayor in the conduct of all labor relations between the City of New York and labor unions representing employees of the City.The Commissioner serves on behalf of the Mayor as the City’s liaison with both labor and management in the private sector.

We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system. Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Review

New Yorkers by uniting communities through care.We believe that Health care is a right, not a privilege.If you have compassion and a collaborative spirit, work with us.You can come to work being proud of what you do every day.Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensi

Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.As a wholly-owned subsidiary of NYC Heal

The Medical Advisor provides clinical and academic oversight for ADOM’s educational and community programs, ensuring the highest standards of ethics, accuracy, and medical integrity. It involves reviewing educational content, guiding faculty in clinical accuracy, and offering professional insight

LaSante Health Center is seeking a Referrals and Prior Authorization Specialist to join our team.The ideal candidate will help ensure patients have seamless access to medications, diagnostic imaging, and specialty care by managing prior authorization requests for insurance and guiding patients throu

The Clinical R&D Research Intern will have the opportunity to rotate through 6 functions in Clinical R&D Department to understand what each position encompasses and learn firsthand the requirements and opportunities in this field of the Biotechnology Industry. The rotations will include medical moni

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guide

Clinical/Allied Health degree/licensure preferred, with at least 5 years of clinical experience in pediatrics, endocrinology, neurology, ENT, orthopedics, or related, and 2 years of industry experience.

The role blends elements of clinical education, therapy coordination, and program development within a patient-focused environment. Ideal candidates will have a background in occupational or physical therapy - or comparable neuro-rehabilitation experience - and enjoy collaborating closely with multi

Emergency Department Medical Scribe Wanted - PT or FT (Yonkers).Synergy Medical Concierge Services is looking to hire an Emergency Department Medical Concierge in Yonkers, NY.We are looking for detail-oriented and personable individuals that possess the ability to work effectively in an Emergency De

This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other rela