Applied Computing Review Jobs in Usa

9,294 positions found — Page 11

Clinical Data Review Pharmacist (onsite)
Salary not disclosed
West Jordan 4 days ago
A-Line Staffing is now hiring a Clinical Data Review Pharmacist in West Jordan, UT 84084.

The Clinical Data Review Pharmacist would be working for a Major Fortune 500 Company and has career growth potential.

Clinical Data Review Pharmacist Highlights: Schedule: ??? 6am to 2pm Monday to Friday ??? Sunday 3-11pm and Monday-Thursday 1-9pm OFF Friday/Saturday Pay Rate: $65/hr Clinical Data Review Pharmacist Responsibilities: Process prescription orders and perform clinical verification Consult with patients and providers as needed Support pharmacy programs that improve patient health outcomes, medication adherence, and prescription accuracy Clinical Data Review Pharmacist Qualifications: BS in Pharmacy or Doctor of Pharmacy (PharmD) Active Pharmacist License (RPh) Minimum 1 year of experience in a pharmacy environment If you are interested in this Clinical Data Review Pharmacist position, please apply to this posting with Luke H.

at A-Line!
Not Specified
Care Review Clinician I
Salary not disclosed
Long Beach 2 days ago
Job Title: Care Review Clinician I Location: 100% Remote Duration: 3 Months+ (temp to hire) Schedule: Wednesday
- Sunday 8 – 5 pm PST Pay Range: $43
- $44/hr.

on W2 Description: · The Care Review Clinician is responsible for performing utilization management (UM) reviews, including prior authorization of outpatient services, to ensure medical necessity, appropriate level of care, and compliance with regulatory and organizational guidelines.

· The clinician will review clinical documentation, apply evidence-based criteria, and collaborate with providers to facilitate timely and appropriate care for members.

· This role supports Client’s commitment to quality, cost-effective care and regulatory compliance within the California health plan.

Must Have Skills: · Knowledge of California delegation requirements · Strong understanding of utilization management processes · Experience with prior authorization review (outpatient preferred) · Ability to apply clinical guidelines (e.g.

MEDICAID, MCG) Day to Day Responsibilities: · Process outpatient prior authorization referrals · Review clinical documentation for medical necessity · Apply established UM criteria and guidelines · Communicate with providers for additional clinical information · Ensure compliance with state, federal, and Client policies · Document determinations accurately and timely Required Years of Experience: · Active, unrestricted California RN or LVN license required · Minimum of 3 years of clinical experience in utilization management
Not Specified
Medical Reviewer
Salary not disclosed
North Chicago, IL 4 days ago

Position Title: Medical Reviewer

Work Location: Remote

Assignment Duration: 12 Months



Job Description:



We are seeking a contract Medical Reviewer to support our international Botox Therapeutic Neurotoxin team. The ideal candidate will be responsible for the medical review of clinical and scientific data related to the use of Botox for various therapeutic indications.

Key responsibilities include ensuring the accuracy and compliance of content with regulatory and company standards, providing expert medical input on clinical documents and safety information, and collaborating with cross-functional teams globally.

Qualifications:

The candidate should have a medical degree (MD or equivalent), clinical experience in neurology, physical medicine, or related fields, and a solid understanding of regulatory requirements for therapeutic neurotoxins. Experience with Botox or neurotoxin therapies is strongly preferred. Excellent communication and detail-orientation are essential.

Must have experience as a Reviewer OUS, understanding regulatory complexities of international markets.



Not Specified
Clinical Review Clinician - Appeals
🏢 Spectraforce Technologies
Salary not disclosed
Raleigh, NC 3 days ago

Position Title: Clinical Review Clinician - Appeals



Work Location: Remote - Nationally sourced (Preference for 2 candidates in AZ)



Assignment Duration: 6 months



Work Schedule: 8:00 AM - 5:00 PM EST or CST



Work Arrangement: Remote



Position Summary

Schedule is 8-5 EST or CST hours. Staff will work when there are members of the supervisor/leadership on.

Cases are assigned in round robin fashion for staff to review and work.



Background & Context

The Organization's clinical team handles various types of authorization and claim review requests from various markets nationwide, processing clinical reviews to ensure members have the best outcomes and access to care needed.



Key Responsibilities



  • Nurses review case files, add, update or edit authorizations.




  • Work closely with the MD team to make final decisions on cases.




  • Process clinical reviews to ensure members have access to care needed.




  • Help reduce provider abrasion by processing retrospective claim reviews.




  • Work closely with supervisors, senior clinicians, and the coordinator team on end-to-end case processes.




  • Participate in team collaboration via Teams group chats for routine questions.





Qualification & Experience



  • Education/Certification (Required): Associate in nursing, Bachelor's in nursing or higher.




  • Licensure (Required): RN, LPN




  • Licensure (Preferred): LVN




  • Must haves:





    • Medicare knowledge




    • InterQual or Milliman Experience




    • Clinical reviews for Utilization Management or Appeals






  • Nice to haves:





    • Medicare Appeals Experience






  • Disqualifiers:





    • Not having a valid/active RN/LPN license






  • Performance indicators:





    • Productivity expectations vary based on platform.




    • Prime: 7 CPD




    • iCP: 9 CPD




    • CenPas: 20 CPD cases per day




    • 95% quality on all cases



      Candidate Requirements

      Education/Certification
      Required: Associate in nursing, Bachelor's in nursing or higher.
      Preferred:

      Licensure
      Required: RN, LPN
      Preferred: LVN


      • Years of experience required
      • Disqualifiers
      • Best vs. average
      • Performance indicators


      Must haves: Medicare knowledge, InterQual or Milliman Experience, Clinical reviews for Utilization Management or Appeals

      Nice to haves: Medicare Appeals Experience

      Disqualifiers: Not having a valid/active RN/LPN license

      Performance indicators: Productivity expectations vary based on platform. Prime 7 CPD, iCP 9 CPD and CenPas is 20 CPD cases per day with 95% quality on all cases

      Best vs. average: Productivity expectations are set based on platform.


      • Top 3 must-have hard skills
      • Level of experience with each
      • Stack-ranked by importance
      • Candidate Review & Selection


      1
      Utilization Management or Appeals review background (1 plus year)

      2
      Medicare NCD/LCD and InterQual/Milliman Software (1 plus year)

      3
      Retrospective claims clinical reviews (1 plus year)



Not Specified
Proofreader/Document Reviewer
✦ New
Salary not disclosed
Houston, TX 1 day ago

JOB DESCRIPTION

We are seeking detail‑oriented Document Reviewers to ensure documents meet defined standards for accuracy, formatting, and compliance. In this role, you will systematically review and compare documents against established guidelines using structured checklists, identify inconsistencies, and proofread for quality and clarity. This position is ideal for individuals with strong attention to detail and experience in editing, proofreading, or document quality review.


Key Responsibilities:

  • Meet productivity and quality benchmarks in a deadline‑driven environment of 100 assets/items per week.
  • Review documents against predefined guidelines and standards using structured checklists..
  • Compare documents for accuracy, consistency, and compliance with requirements.
  • Identify and document errors, omissions, formatting issues, and inconsistencies.
  • Proofread content for grammar, spelling, punctuation, and overall clarity.
  • Verify document formatting, layout, and presentation align with established standards.
  • Confirm documents have incorporated recommended changes
  • Record findings clearly and escalate issues as needed.
  • Maintain accuracy and consistency while handling repetitive review tasks.


REQUIRED:

  • 2+ years of experience reviewing documents for accuracy on a daily basis.
  • Strong attention to detail and ability to spot inconsistencies or errors.
  • Excellent reading comprehension and written communication skills.
  • Comfort working with structured checklists and completing repetitive tasks.


PREFERRED:

  • Degree or coursework in English, Communications, Journalism, Writing, or a related field.
  • Experience working with style guides or compliance‑based documentation.
  • Familiarity with educational formatting standards and document comparison processes.


LOCATION:

  • This role requires you to live in Houston, TX or a surrounding area, so you can be on-site at least once every three months for meetings etc.
  • When not on-site, you can work from home.


HOURS:

  • 7am – 3:30pm or 7:30am – 4pm CST.
  • Monday – Friday.


DURATION:

  • This is a contract job through April of 2027.
Not Specified
Review Assistant/CSR
✦ New
Salary not disclosed
Des moines, IA 1 day ago
Review Assistant II

The Review Assistant II is responsible for inbound and outbound communication in support of case review activities including collection and confirmation of data integrity in support of clinical review services.

Essential functions include interpreting review guidelines to facilitate forward movement of the case review process including requests for clinical information, treatment plans, and more.

Not Specified
Document Review Attorney (Onsite Only)
Salary not disclosed

Ready to Rock Your Document Review Skills?

Hey legal eagles! Are you a newly licensed attorney looking for an exciting, long-term project that lets you flex your document review muscles? A fantastic firm in the Charleston, SC area is on the hunt for sharp onsite Document Review Attorneys to jump into an immediate, 6+ month gig. This isn't just another project; it's a chance to supercharge your resume and gain invaluable experience with a team that truly values you. Please note, if you have done extensive document review for Defense firms, you are likely conflicted out.

What You'll Be Doing as a Document Review Attorney (Your Superpower Moves!):

  • Sleuthing through documents with precision and speed, using Relativity or other cool e-discovery software.
  • Uncovering crucial information and sharing those "aha!" moments with your team leaders.
  • Crafting top-notch litigation documents, like those all-important Deposition Dossiers.
  • Tackling other fascinating tasks as your project leaders need a hand.

Who We're Searching For (Are You Our Next Superstar?):

  • You've got that shiny JD from an ABA-accredited law school.
  • You're either a licensed member of the SC Bar, or have a UBE score ready to transfer to SC, or are licensed in another state.
  • You're a detail-oriented dynamo – thorough, organized, and nothing gets past your eagle eyes.
  • You're a master of managing your time and can work independently like a pro.
  • Your communication skills, both written and verbal, are top-notch.
  • Bonus points if you're already a Relativity guru or have document review attorney experience, but no worries if not – we're ready to help you learn!
  • You've got that natural knack for problem-solving.

The Sweet Deal (What's In It For You!):

  • Competitive hourly rates ranging from $27 to $30.
  • Subsidized health insurance for our awesome full-time reviewers!

Be ready to pass a comprehensive conflicts check! And rest assured, your resume is held in the strictest confidence.

Think you're a fit? We can't wait to hear from you! Apply at : This job description is not intended to be all-inclusive. The employee may perform other related duties as negotiated to meet the ongoing needs of the organization.

Not Specified
Paralegal (Contracts & SOW Review)
✦ New
Salary not disclosed
Atlanta, Georgia 1 day ago

Paralegal (Contracts & SOW Review)

Our client is seeking a Paralegal to support contract review and remediation initiatives across third-party vendor agreements. This role is ideal for a paralegal with experience reviewing and revising Statements of Work (SOWs) and corporate vendor contracts in a fast-paced enterprise environment. You will work closely with procurement, legal, and business stakeholders to ensure agreements are accurate, compliant, and aligned with corporate governance standards.

As part of our process after applying, you may receive an invitation from our AI Recruiter Avery for a short conversation that lets you share more about your background beyond your resume. For questions, contact

• Location: Atlanta, GA (Hybrid)

• Compensation: This job is expected to pay about $32–$36/hr W2

• Job Type: Contract

• Duration: 12+ Month Contract (Potential to extend or convert to full-time)

• No Visa Sponsorship Available for this role

What You'll Do:

• Review and revise Statements of Work (SOWs) and vendor agreements to ensure contract terms align with internal policies and governance standards.

• Support ongoing contract remediation initiatives, analyzing contract language and coordinating updates with legal and procurement teams.

• Partner with procurement, category management, finance, and legal teams to ensure contracts accurately reflect scope, pricing, and service terms.

• Track contract revisions and maintain documentation throughout the contract lifecycle.

• Serve as a point of contact for stakeholders regarding contract updates, compliance questions, and agreement changes.

What Gets You the Job:

• 3–5 years of experience reviewing and revising corporate contracts or Statements of Work (SOWs).

• Paralegal experience required, preferably supporting corporate contracts or vendor agreements.

• Experience working in an enterprise or professional services environment.

• Bachelor's degree required; Paralegal certificate or legal studies background is a plus.

• Strong attention to detail with the ability to review and update contract language accurately.

• Excellent communication and stakeholder management skills.

Irvine Technology Corporation (ITC) connects top talent with exceptional opportunities in IT, Security, Engineering, and Design. From startups to Fortune 500s, we partner with leading companies nationwide. Our AI recruiter, Avery helps streamline the first step of your journey—so we can focus on what matters most: helping you grow. Join us. Let us ELEVATE your career!

Irvine Technology Corporation provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Irvine Technology Corporation complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities.

Not Specified
Attorney - Document Review
Salary not disclosed
New York, NY 3 days ago

The Opportunity:

A government agency seeks two admitted Document Review Attorneys for a short-term document review project scheduled to begin in early March with a duration of approximately four months. Must be available to work at least 35 hours weekly and additional hours, if needed. The hourly rate is $50, plus benefits.


Primary Duties:

The Document Review Attorneys will help coordinate the compliance review of filed election documents. Candidates must be comfortable navigating high volume and strict statutory timelines for review, hearings and providing notice and able to utilize the agency's digital systems for viewing scanned documents and generating letters. Additional duties include the following:


  • Preparation of letters of non-compliance
  • Compiling records for related hearings and litigation


Experience & Qualifications:

  • New York State bar admission
  • Minimum of 2- 5 years of legal experience
  • Experience with digital document management systems


Frink-Hamlett Legal Solutions is an equal employment opportunity employer and all applicants will receive consideration for employment without discrimination based on race, color, creed, national origin, sex, age, disability, marital status, sexual orientation or citizenship status.

Not Specified
Hospital RN – Care Coordination & Utilization Review
Salary not disclosed
San Jose, CA 1 week ago

Immediate need for a talented Hospital RN – Care Coordination & Utilization Review . This is a 06+months contract opportunity with long-term potential and is located in San Jose, CA (Onsite). Please review the job description below and contact me ASAP if you are interested.


Job ID: 25-80861


Pay Range: $80 - $95/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).


Key Responsibilities:


  • Conduct utilization reviews using InterQual® / MCG®
  • Support discharge planning and post-acute coordination
  • Communicate with physicians, social work, and external providers
  • Manage authorizations and payer-related workflows
  • Maintain compliance with regulatory standards


Key Requirements and Technology Experience:


  • Key Skills; CA RN License (Active)
  • Acute inpatient hospital experience
  • UM / Case Management / Discharge Planning background


Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.


Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.


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Not Specified
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