nurse reviewer

Elevance Health

<div>
 <strong>
  Location:
 </strong>
 This role enables associates to work virtually full-time, except for 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 development.
 <br/>
 <br/>
 Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
 <br/>
 <br/>
 A proud member of the Elevance Health family of brands, Carelon Health (formerly CareMore Health) offers clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.
 <br/>
 <br/>
 <strong>
  Work Hours:
 </strong>
 Monday - Friday (9:30 AM -6:00 PM Centeral)
 <br/>
 <br/>
 The
 <strong>
  Nurse Reviewer I
 </strong>
 is responsible for conducting preauthorization, out of network and appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines. Collaborates with healthcare providers, and members to promote the most appropriate, highest quality and effective use of diagnostic imaging to ensure quality member outcomes, and to optimize member benefits. Works on reviews that are routine having limited or no previous medical review experience requiring guidance by more senior colleagues and/or management. Partners with more senior colleagues to complete non-routine reviews. Through work experience and mentoring learns to conduct medical necessity clinical screenings of preauthorization request to assess assessing the medical necessity of diagnostic imaging procedures, out of network services, and appropriateness of treatment.
 <br/>
 <br/>
 <strong>
  How You Will Make An Impact
  <br/>
  <br/>
 </strong>
 <strong>
  Primary duties may include, but are not limited to:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Conducts initial medical necessity clinical screening and determines if initial clinical information presented meets medical necessity criteria or requires additional medical necessity review.
  </li>
  <li>
   Conducts initial medical necessity review of exception preauthorization requests for services requested outside of the client health plan network.
  </li>
  <li>
   Notifies ordering physician or rendering service provider office of the preauthorization determination decision.
  </li>
  <li>
   Follows-up to obtain additional clinical information.
  </li>
  <li>
   Ensures proper documentation, provider communication, and telephone service per department standards and performance metrics.
  </li>
  <li>
   Other duties as assigned
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Minimum Qualifications
  <br/>
  <br/>
 </strong>
 Requires AS in nursing and minimum of 3 years of clinical nursing experience in an ambulatory or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which would provide an equivalent background. Current unrestricted RN license in applicable state(s) required.
 <br/>
 <br/>
 <strong>
  Preferred Skills, Capabilities And Experiences
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Familiarity with Utilization Management Guidelines is preferred
  </li>
  <li>
   ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly preferred.
  </li>
  <li>
   BA/BS degree preferred.
  </li>
  <li>
   Previous utilization and/or quality management and/or call center experience preferred.
  </li>
  <li>
   Proficiency in Microsoft Office Products is strongly preferred
   <br/>
   <br/>
  </li>
 </ul>
 For candidates working in person or virtually in the below locations, the salary* range for this specific position is $34.69 to $54.41 (hourly)
 <br/>
 <br/>
 <strong>
  Location(s):
 </strong>
 California, Illinois, Minnesota
 <br/>
 <br/>
 In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.
 <br/>
 <br/>
 <ul>
  <li>
   The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company&rsquo;s sole discretion, consistent with the law.
   <br/>
   <br/>
  </li>
 </ul>
 Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
 <br/>
 <br/>
 Who We Are
 <br/>
 <br/>
 Elevance Health is a health company dedicated to improving lives and communities &ndash; and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
 <br/>
 <br/>
 How We Work
 <br/>
 <br/>
 At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
 <br/>
 <br/>
 We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
 <br/>
 <br/>
 Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
 <br/>
 <br/>
 The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
 <br/>
 <br/>
 Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
 <br/>
 <br/>
 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
</div>


Nurse Reviewer I

Acentra Health

<div>Company Overview:
<div>
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.</div><div></div><div><br>
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes &ndash; making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.</div>
Job Summary and Responsibilities:
<p><b>
Acentra seeks a Clinical Reviewer to join our growing team.</b></p><p></p><p><b><br>
Job Summary:</b></p><p></p><p><br>
The purpose of this position is to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness.</p><div></div><div><b><i><br>
**Shift hours will be 8:00am to 4:30pm EST including weekend and holiday rotations**</i></b></div><div></div><div><b><br>
Job Responsibilities:</b></div><ul><li>
Assures accuracy and timeliness of all applicable review type cases within contract requirements.</li><li>
Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department.</li><li>
In collaboration with Supervisor, responsible for the quality monitoring activities including identifying areas of improvement and plan implementation of improvement areas.</li><li>
Maintains current knowledge base related to review processes and clinical practices related to the review processes, functions as the initial resource to nurse reviewers regarding all review process questions and/or concerns.</li><li>
Functions as providers&rsquo; liaison and contact/resource person for provider customer service issues and problem resolution.</li><li>
Performs all applicable review types as workload indicates.</li><li>
Fosters positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building to facilitate the review process.</li><li>
Attends training and scheduled meetings and for maintenance and use of current/updated information for review.</li><li>
Cross trains and perform duties of other contracts to provide a flexible workforce to meet client/customer needs.</li><li>
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules</li></ul><p></p><p><i><br>
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.</i>
</p>Qualifications:
<p><b>
Required Qualifications/Experience:</b></p><ul><li>
Active unrestricted RN or, or other applicable State and/or Compact State clinical license per contract requirements.</li><li>
Requires a Bachelor&rsquo;s Degree from an accredited college or university in a related field.</li><li>
Must be able to work a schedule of 8:00am to 4:30pm EST including a weekend and holiday rotation.</li></ul><p><b>
Preferred Qualifications/Experience:</b></p><ul><li>
Knowledge of the organization of medical records, medical terminology, and disease process required.</li><li>
Strong clinical assessment and critical thinking skills required. Medical record abstracting skills required.</li><li>
Requires excellent written and verbal communication skills.</li><li>
Medical record abstracting skills required.</li></ul><div><b>
Why us?</b></div><div></div><div><br>
We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.</div><div></div><div><b><br>
We do this through our people.</b></div><div></div><div><br>
You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.</div><div></div><div><b><br>
Benefits</b></div><div></div><div><br>
Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.</div><div></div><div><b><br>
Compensation</b></div><div></div><div><br>
The pay range for this position is listed below.</div><div></div><div><br>
&ldquo;Based on our compensation philosophy, an applicant&rsquo;s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.&rdquo;</div><div></div><div><b><br>
Thank You!</b></div><div></div><div><br>
We know your time is valuable and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!</div><div></div><div><br>
~ The Acentra Health Talent Acquisition Team</div><div></div><div><br>
Visit us at https://careers.acentra.com/jobs</div><div></div><div><b><br>
EEO AA M/F/Vet/Disability</b></div><div></div><div><br>
Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.</div>
Pay Range: USD $28.00 - USD $32.00 /Hr.</div>

Clinical Reviewer - RN (SCA - Remote)

Cactus Communications

<div>
 We are currently looking for
 <strong>
  researchers, retired researchers, and former researchers
 </strong>
 who can perform peer reviews for journals and publishers.
 <br/>
 <br/>
 <strong>
  Note:
 </strong>
 You should be able to disclose your full name and affiliations with the publishers.
 <br/>
 <br/>
 <strong>
  WHAT YOU NEED to Have:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Doctorate (PhD/MD) or equivalent advanced degree in the subject area.
  </li>
  <li>
   At least two publications in the last two years in your field.
  </li>
  <li>
   Thorough understanding of research methodologies and ethical principles within the relevant discipline.
  </li>
  <li>
   Excellent analytical and critical thinking skills.
  </li>
  <li>
   Strong written communication skills with the ability to provide clear, concise, and constructive feedback.
  </li>
  <li>
   Ability to adhere to deadlines and manage time effectively.
  </li>
  <li>
   Commitment to maintaining confidentiality and objectivity.
  </li>
  <li>
   Prior experience as a peer reviewer for academic journals is highly desirable.
  </li>
  <li>
   Familiarity with online manuscript submission and review systems.
   <br/>
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  WHAT YOU WILL DO:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Assess Novelty: Assess whether the manuscript is original and adds new knowledge or insights to the field of study.
  </li>
  <li>
   Evaluate Study Design and Methodology: Assess whether the study design and methods are appropriate, comprehensive, and clearly described to ensure that the research can be accurately reproduced in the future.
  </li>
  <li>
   Literature Review: Check whether the manuscript thoroughly incorporates and cites relevant, up-to-date research in the field.
  </li>
  <li>
   Analyse Results and Conclusions: Evaluates whether the results are presented clearly and appropriately, and whether the conclusions are supported by the data and significant to the field.
  </li>
  <li>
   Providing Constructive Feedback: Provide constructive feedback, suggesting improvements or highlighting any flaws, omissions, or ethical concerns.
  </li>
  <li>
   Recommend Publication: Based on your evaluation, the journal editor will decide whether the manuscript should be accepted, revised, or rejected.
  </li>
 </ul>
</div>


Freelance Peer Reviewer - Obstetrics, Gynecology, and Reproductive Medicine

Sharp HealthCare

<div>[Doctor of Medicine (MD); Doctor of Osteopathic Medicine (DO); California Physicians and Surgeons License - Medical Board of CA<p><b>
Hours</b><b>:</b></p><p></p><p><b>
Shift Start Time:</b></p>
8 AM<p><b>
Shift End Time:</b></p>
5 PM<p></p><p><b>
AWS Hours Requirement:</b></p>
8/40 - 8 Hour Shift<p></p><p><b>
Additional Shift Information:</b></p><p></p><p><b>
Weekend Requirements:</b></p>
No Weekends<p></p><p><b>
On-Call Required:</b></p>
No<p></p><p><b>
Hourly Pay Range (Minimum - Midpoint - Maximum):</b></p>
$90.510 - $116.790 - $130.800<p></p><p><br>
The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant&rsquo;s years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.</p><p></p><p><b><br>
Please Note:</b> As part of our recruitment process, you may receive communication from Dawn, our virtual recruiting assistant. Dawn helps coordinate scheduling for screening calls and interviews to ensure a smooth and timely experience. Rest assured, all candidate evaluations and hiring decisions are made by our recruitment and hiring teams.</p><p><b><br>
What You Will Do</b><br>
The position is responsible for the medical direction of Authorization Review for Sharp Health Plan (SHP). The Physician Reviewer will perform all reasonably necessary functions to ensure quality of care and appropriate utilization in the most cost-effective, appropriate and professional manner, which meets the expressed needs of patients and professional colleagues.<br>
<br>
<b>Required Qualifications</b></p><ul><li>
Doctor of Medicine (MD) Or</li><li>
Doctor of Osteopathic Medicine (DO)</li><li>
5 Years Experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review</li><li>
California Physicians and Surgeons License - Medical Board of CA -REQUIRED</li></ul><p><b><br>
Other Qualification Requirements</b></p><ul><li>
Board Certification in Internal Medicine or Family Medicine preferred.</li></ul><p><b><br>
Essential Functions</b></p><p></p><ul><li>
Customer service<br>
Provides prompt, accurate and excellent services to internal and external customers. Develops solid professional working relationships with various internal departments and units and as required, vendors and providers.</li><li>
General support<br>
Participates in special projects and other duties as assigned. These may include, but are not limited to, work groups, audits and back-up medical management support for the Chief Medical Officer.</li><li>
Professional competency<br>
Maintain current knowledge of the service denial process and pertinent health plan authorization criteria and regulations. Keeps abreast of advances in medical care methodologies that may contribute to enhanced quality of services and effective utilization of services.</li><li>
Provider interaction<br>
Periodically presents information regarding authorization services at various SHP meetings on an as needed basis. Provides educational support for PCPs both on a &quot;program&quot; basis and one-on-one basis as needed in regard to proper utilization authorization. Provides strong leadership and direction for appropriate and efficient prior authorization services.</li><li>
Training<br>
Participate in Milliman and Hayes Technology Assessments training or have plans to do so (whether independently or through SHP).</li></ul><p></p><p><b><br>
Knowledge, Skills, and Abilities</b></p><p></p><ul><li>
Knowledge of physician social and political behavior and managed care philosophy.</li><li>
Demonstrate effective communication skills, ability to work collaboratively with medical leadership and administration of SHP, medical staff, nurses, and Sharp Hospital administration.</li></ul><p></p><p>
Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability or any other protected class</p></div><p></p>

Physician Reviewer - Sharp Health Plan - Hybrid / Telecommuter - Day Shift - Part Time

Romeo Staffing Agency

<p>Job Title: Registered Nurse &ndash; NCLEX Qualified (Quality Assurance) Location: Model Colony / Malir, Karachi (near the Airport) Salary: Market Competitive (Depending on Experience) Timing: 6 PM &ndash; 3 AM (Monday to Friday) Company: Romeo Staffing Agency (RSA)</p><p>About the Role</p><p>Romeo Staffing Agency is seeking a detail-oriented and clinically experienced Registered Nurse &ndash; NCLEX Qualified (Quality Assurance ) to support quality, compliance, and clinical documentation standards for our US-based home health and hospice clients. The RN QA will be responsible for reviewing nursing documentation, ensuring regulatory compliance, and maintaining high standards of patient care in alignment with US healthcare guidelines and best practices.</p><p>This role is ideal for an NCLEX-qualified Registered Nurse with strong analytical skills, a solid understanding of home health or hospice documentation, and an interest in international healthcare quality, compliance, and clinical excellence.</p><p>Key Responsibilities</p><p>Clinical Documentation Review:</p><p>Review nursing documentation including patient charts, OASIS assessments, plans of care, visit notes, and discharge summaries for accuracy, completeness, and clinical appropriateness. Ensure documentation complies with Medicare, CMS, and agency-specific standards. Identify clinical and documentation gaps, errors, or inconsistencies and provide clear, professional feedback to clinicians.</p><p>Quality Assurance &amp; Compliance:</p><p>Monitor compliance with US home health and hospice regulations, policies, and evidence-based nursing practices. Support internal quality improvement initiatives, chart audits, and performance reviews. Assist with accreditation readiness, regulatory surveys, and ongoing compliance monitoring.</p><p>Clinical Coordination &amp; Communication:</p><p>Collaborate with US-based clinical leadership, QA teams, and field clinicians to resolve documentation and quality issues. Follow up with nurses regarding required corrections, updates, and best practice guidance. Maintain strict confidentiality and professionalism in all clinical communications.</p><p>Reporting &amp; Performance Tracking:</p><p>Maintain QA audit logs, clinical quality trackers, and compliance reports. Analyze trends, identify recurring deficiencies, and recommend improvement strategies. Provide quality-related insights and reports to management as required.</p><p>Requirements</p><p>Bachelor&rsquo;s degree in Nursing (BSN) required. Completed NCLEX-RN examination (mandatory). Valid Registered Nurse (RN) license (Pakistan or international experience preferred). 1&ndash;3 years of clinical nursing experience in home health, hospice, or quality assurance. Strong knowledge of US home health or hospice documentation and regulatory standards (OASIS experience is a strong plus). Excellent English communication skills, both written and verbal. Exceptional attention to detail with strong clinical judgment, analytical, and organizational skills. Proficiency in EMRs, QA tools, and cloud-based clinical systems. Willingness to work night shifts to align with US-based operations.</p><p>Why Join Romeo Staffing Agency?</p><p>Work closely with US-based healthcare organizations and clinical teams. Gain hands-on experience in international nursing quality assurance and regulatory compliance. Structured and supportive work environment with learning and career growth opportunities. Exposure to US regulatory standards and real-time clinical QA operations.</p><p>Job Type: Full-time</p><p>Work Location: In person</p><p>Job Type: Full-time</p><p>Pay: Rs90,000.00 - Rs120,000.00 per month</p><p>Work Location: In person</p>

Registered Nurse – NCLEX Qualified (Quality Assurance)

Centene Corporation

<div>
 You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 <br/>
 <br/>
 <ul>
  <li>
   POSITION IS REMOTE WITH POTENTIAL FOR WEEKENDS, HOLIDAYS AND ON-CALL***
  </li>
  <li>
   COMPACT LICENSE REQUIRED***
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Position Purpose
 </strong>
 Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Assists evaluating inpatient services to validate the necessity and setting of care being delivered to the member.
 <br/>
 <br/>
 <ul>
  <li>
   Performs concurrent reviews of member for appropriate care and setting to determine overall health and appropriate level of care
  </li>
  <li>
   Reviews quality and continuity of care by reviewing acuity level, resource consumption, length of stay, and discharge planning of member
  </li>
  <li>
   Works with Medical Affairs and/or Medical Directors as needed to discuss member care being delivered
  </li>
  <li>
   Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines
  </li>
  <li>
   Works with healthcare providers to approve medical determinations or provide recommendations based on requested services and concurrent review findings
  </li>
  <li>
   Assists with providing education to providers on utilization processes to ensure high quality appropriate care to members
  </li>
  <li>
   Provides feedback to leadership on opportunities to improve appropriate level of care and medically necessity based on clinical policies and guidelines
  </li>
  <li>
   Reviews member&rsquo;s transfer or discharge plans to ensure a timely discharge between levels of care and facilities
  </li>
  <li>
   Collaborates with care management on referral of members as appropriate
  </li>
  <li>
   Performs other duties as assigned
  </li>
  <li>
   Complies with all policies and standards
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Education/Experience
 </strong>
 Requires Graduate from an Accredited School of Nursing or Bachelor&rsquo;s degree in Nursing and 2 &ndash; 4 years of related experience. 2+ years of acute care experience required.
 <br/>
 <br/>
 Clinical knowledge and ability to determine overall health of member including treatment needs and appropriate level of care preferred.
 <br/>
 <br/>
 Knowledge of Medicare and Medicaid regulations preferred.
 <br/>
 <br/>
 Knowledge of utilization management processes preferred.
 <br/>
 <br/>
 <strong>
  License/Certification
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   LPN - Licensed Practical Nurse - State Licensure required
   <br/>
   <br/>
  </li>
 </ul>
 Pay Range $27.02 - $48.55 per hour
 <br/>
 <br/>
 Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
 <br/>
 <br/>
 Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
 <br/>
 <br/>
 Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
</div>


Clinical Review Nurse – Concurrent Review

MERJE Ltd

<p>Our client, an award winning independent financial advice firm are looking for a File Reviewer to join the team on a permanent basis. </p> <p>As File Reviewer you will assist the Head of Compliance inin all aspects of the compliance regime, including: </p> <p><u><strong>Role Responsibilities:</strong></u></p> <ul> <li>Conduct pre- and post-sale reviews of client files to ensure advice suitability and regulatory compliance</li><li>Identify and flag potential risks or areas for improvement</li><li>Provide constructive feedback to advisers in a supportive and professional manner</li><li>Keep up-to-date with FCA regulations and internal policies</li><li>Contribute to the development and delivery of internal training as required</li><li>Maintain accurate records of all reviews and follow-up actions</li><li>Previous experience in a file reviewer/checker role. </li></ul> <p><u><strong>Key Skills & Experience:</strong></u></p> <ul> <li>Industry qualifications desirable but not essential e.g. CII Diploma in Regulated Financial Planning or another Accredited Body qualification</li><li>Financial services industry experience, for which you can demonstrate working examples of key tasks</li><li>Strong knowledge of FCA requirements and industry best practice</li><li>Ability to form good working relationships</li><li>Ability to work under pressure</li><li>Ability to display model behaviours in line with group values, policies and procedure </li></ul> <p><em>Please note, should feedback not be received within 28 days due to the large volume of applications, unfortunately, your application has been unsuccessful. However, we may be in touch with similar relevant opportunities.</em></p> <p><em>If you would like this job advertisement in an alternative format, please contact MERJE directly.</em></p>

Compliance File Reviewer

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