medical reviewer jobs in Cuyahoga County, OH

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC). MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work! MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the...

Immediate RN Clinical Consultant - ADA Medical Accommodation Review remote contract opportunity. This is a 100% remote/work from home position. Pay Rate: $85.00/hr Work Details: - Monday to Friday / 40 hours per week - Work from home/remote position Contract Details: - Start Date: ASAP - End Date: 12/31/2025 (possible extension) Job Details: - The Clinical Consultant is responsible 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 Description GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Middleburg Heights, Ohio. Job Description & Requirements - Specialty: Utilization Review - Discipline: RN - Start Date: ASAP - Duration: 14 weeks - 40 hours per week - Shift: 8 hours, days - Employment Type: Travel Contract - W2 Case Management/Utilization Review Registered...

Job Description Solomon Page is seeking a travel nurse RN Utilization Review for a travel nursing job in Middleburg Heights, Ohio. Job Description & Requirements - Specialty: Utilization Review - Discipline: RN - Start Date: ASAP - Duration: 14 weeks - 40 hours per week - Shift: 8 hours - Employment Type: Travel Our client is looking to add a Registered Nurse to their team. \n\n Job...

TravelNurseSource is working with GQR Healthcare to find a qualified Utilization Review RN in Middleburg Heights, Ohio, 44130! Pay Information $2,118 per week About The Position Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Middleburg Heights, Ohio Start Date: December 1, 2025 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2118.2 -...

Description Perform independent commercial real estate appraisal reviews on high complexity/risk properties. The Senior Risk Reviewer will be assigned to larger exposure, more complex collateral typically resulting in greater risk to Citizens, whereby the reliance on experience is critical to identify major issues to protect the bank's collateral position. Ascertain compliance of appraisal...

Global Tax Quality Review Program Leader Overview: The Global Tax Quality Review Program Leader reports to the Global Tax Quality Leader and will lead EY’s Tax Quality Review Program, a strategic initiative designed to enhance the quality, consistency, and compliance of tax services across global markets. The role offers exposure to a wide range of tax services, regulatory environments, and...

Job Title: Utilization Review Specialist Location: Highland Springs in Highland Hills, OH Schedule: Full Time, Day Shift Your experience matters At Highland Springs, we are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Here, you're not just valued as an employee, but as a person. As a Behavioral Health Technician (BHT) joining our...

Virtual Utilization Review Supervisor Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping...

Utilization Review Specialist The Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine the legitimacy of admission, treatment, and the length of stay and interfaces with managed care organizations, external reviewers, and other payers. UR advocates on behalf of patients with substance abuse, dual...

Anticipated End Date2025-12-12Position TitleNurse Reviewer I (US)Job DescriptionWork location - Virtual: This role enables associates to work virtually full‑time, with the exception of required in‑person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill...

Job DescriptionUtilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional...

TravelNurseSource is working with GQR Healthcare to find a qualified Utilization Review RN in Middleburg Heights, Ohio, 44130! Pay Information $2,118 per week About The Position Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Middleburg Heights, Ohio Start Date: December 1, 2025 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2118.2 -...

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...

Solomon Page is seeking a travel nurse RN Utilization Review for a travel nursing job in Middleburg Heights, Ohio. Job Description & Requirements - Specialty: Utilization Review - Discipline: RN - Start Date: ASAP - Duration: 14 weeks - 40 hours per week - Shift: 8 hours - Employment Type: Travel Our client is looking to add a Registered Nurse to their team. Job Details: - Location:...

GQR Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Middleburg Heights, Ohio. Job Description & Requirements - Specialty: Utilization Review - Discipline: RN - Start Date: 12/01/2025 - Duration: 14 weeks - 40 hours per week - Shift: 8 hours, days - Employment Type: Travel Contract - W2 Case Management/Utilization Review Registered Nurse (RN)...

JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care...

Job Description Job Summary Provides support for coordination of benefits review activities that directly impact medical expenses and premium reimbursement. Responsible for primarily coordinating benefits with other carriers responsible for payment. Facilitates administrative support, data entry, and accurate maintenance of other insurance records. Job Duties - Provides telephone,...

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...