Remote Nurse Reviewer: UM/QR & Medical Necessity Job at Luminare Health Benefits Inc., New York, NY

  • Luminare Health Benefits Inc.
  • New York, NY

Job Description

Health Care Service Corporation seeks a Nurse Reviewer to ensure compliance with Utilization Management and Quality Review functions for the health plan. The role requires 5+ years of experience as a Nurse Reviewer or Clinical Reviewer, and involves benefit determinations and medical necessity reviews. This remote position requires an unrestricted RN license, strong analytical and communication skills, and willingness to travel if needed. #J-18808-Ljbffr

Job Tags

Similar Jobs

HTU

Entry Level Communications Representative Job at HTU

 ...media coverage and prepare reports summarizing key messages and public sentiment.Help organize and coordinate internal events and...  ...company is looking for:Bachelor's degree in Communications, Public Relations, Marketing, or a related field.Strong written and verbal... 

Flytrex

Real Estate & Development Manager - Houston Job at Flytrex

 ...who want to join our Operations Team in Houston. As a Real Estate and Development Manager, youll work directly with our leadership teams identifying...  ...of land use planning, zoning, permitting, and commercial and mixed-use development. Key Responsibilities:... 

HunaTek Government Solutions

CCIE Network Engineer Job at HunaTek Government Solutions

 ...Position Summary: Hunatek is seeking a CCIE Network Engineer who is expected to combine deep Cisco expertise with modern security and monitoring skills, particularly in Zero Trust (Zscaler) and enterprise network operations. Essential Job Functions: Network... 

Impleo

Game Artist Intern: Create Real In-Game Art & UI Job at Impleo

 ...Impleo is seeking a passionate Game Artist Intern in the United States to contribute to creating in-game art and UI assets. As part of the Creative Department, you will collaborate on exciting projects, gaining hands-on experience while learning about art production in... 

NOV

Associate Software Engineer - Pathway (June 2027 & January 2027) Job at NOV

 ...JOB DESCRIPTION NOV is actively recruiting ambitious college/university graduates for a Software Engineer role to be part of our Pathway Rotational...  ..., Texas . The NOV Pathway Rotational Program offers recent college graduates the opportunity to obtain meaningful...