medical reviewer jobs in Chandler, AZ

Job DescriptionJob SummaryThe Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.This position will be...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and...

A healthcare consulting firm is seeking a Physician Reviewer/Advisor for Independent Medical Exams (IME) in Phoenix, Arizona. The role involves reviewing medical records, ensuring compliance with client-specific criteria, and providing advisory opinions. This position offers robust opportunities for supplemental income, schedule flexibility, and does not establish a doctor/patient relationship....

Job Summary and ResponsibilitiesUnder the general direction of the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of resources; promote quality patient care; assist with patient care management; comply with applicable standards and regulations and provide information and education to...

Copper Springs EastJob Title: Utilization Review SpecialistJob Type: Full-timeYour experience mattersAt Copper Springs East, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities.What we offerFundamental to providing great care is supporting and rewarding our team. In...

Do you want your voice heard and your actions to count?Discover your opportunity with Mitsubishi UFJ Financial Group (MUFG), one of the world's leading financial groups. Across the globe, we're 150,000 colleagues, striving to make a difference for every client, organization, and community we serve. We stand for our values, building long-term relationships, serving society, and fostering shared...

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose...

Job DescriptionCopper Springs EastJob Title: Utilization Review SpecialistJob Type: Full-timeYour experience mattersAt Copper Springs East, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities.What we offerFundamental to providing great care is supporting and rewarding our...

Nurse First is seeking a travel nurse RN Med Surg for a travel nursing job in Chandler, Arizona. Job Description & Requirements - Specialty: Med Surg - Discipline: RN - Start Date: 01/05/2026 - Duration: 13 weeks - 36 hours per week - Shift: 12 hours, nights - Employment Type: Travel Looking for a great Travel Med Surg Nursing Job in Chandler, Arizona? Nurse First posted this Travel Nursing...

Job DescriptionJob SummaryThe Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.This position will be...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and...

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing...

JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide...

For this position we are seeking a (RN) Registered Nurse who must hold a compact license.This is a Remote position, home office with internet connectivity of high speed requiredWork Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work on set schedule)Looking for a RN with experience with appeals, claims review, and medical coding.JOB DESCRIPTION Job SummaryProvides support for...

Job DescriptionJob SummaryThe Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.This position will be...

Job DescriptionJob SummaryThe Medical Review Nurse provides support for medical claim and internal appeals review activities - ensuring alignment with applicable state and federal regulatory requirements, Molina policies and procedures, and medically appropriate clinical guidelines. Contributes to overarching strategy to provide quality and cost-effective member care.This position will be...

A leading healthcare organization is seeking a Medical Review Nurse to support medical claim and appeals review activities. This role requires an active RN license and at least 2 years of clinical nursing experience. The candidate should be skilled in analytics, problem-solving, and have a solid understanding of medical coding. This remote position offers a competitive hourly pay ranging from...

JOB DESCRIPTION Job SummaryProvides support for clinical member services review assessment processes. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations - ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to provide...

For this position we are seeking a (RN) Registered Nurse who must hold a compact license.This is a Remote position, home office with internet connectivity of high speed requiredWork Schedule Monday to Friday - operation hours 6 AM to 6 PM (Team will work on set schedule)Looking for a RN with experience with appeals, claims review, and medical coding.JOB DESCRIPTION Job SummaryProvides support for...

Job DescriptionWork hours will be 7am-3:30pm PST M-FJob SummaryResponsible for conducting various healthcare Healthcare claim audits including, but not limited to; vendor, focal, audit the auditor. Confirm that documentation is clear and concise to ensure accuracy in auditing of critical information on claims ensuring adherence to business and system requirements of customers as it pertains to...