Exeter Review Jobs in Usa
6,481 positions found — Page 2
Essential Functions of the job:
- Review and validate QC data and test records.
- Support investigations related to Out of Specification (OOS), Out of Trend (OOT), and Out of Expectation (OOE) results.
- Ensure compliance with current Good Manufacturing Practices (cGMP) in the laboratory.
- Assist in the technical documentation of investigations and change control assessments to evaluate the impact on product quality, in alignment with FDA/EU regulations, international standards
- Undertake other duties as required.
This position is ideal for candidates who are detail-oriented and committed to quality assurance in the pharmaceutical industry.
Education/Experience Required:
- Bachelor’s Degree or above in Chemistry, Biochemistry, or Biotechnology related scientific discipline. Scientific degree (ideally chemistry, biochemistry, biotechnology or related).
- Minimum 4 years working experience in an FDA-regulated biotechnology or pharmaceutical company is required.
- Working knowledge and experience with chemistry analytical methods such as HPLC, GC, TOC, Capillary Electrophoresis (CGE-Reduced, CGE-Non-Reduced, and Capillary Zone Electrophoresis), etc.
- Strong working knowledge with USP/EP and cGMP/EU GMP.
- Technical writing experience.
- Familiar with instrument and equipment validation.
- Impressive, demonstrable track record and skills/experience gained within a similar position(s), at a similar level.
- Credible and confident communicator (written and verbal) at all levels.
- Strong analytical and problem-solving ability.
- Hands-on approach, with a ‘can do’ attitude.
- Ability to prioritize, demonstrating good time management skills.
- Excellent attention to detail, with the ability to work accurately in a busy and demanding environment.
- Self-motivated, with the ability to work proactively using own initiative.
- Committed to learning and development
- Self-motivated, with the ability to work proactively using own initiative.
Computer Skills:
- Strong PC literacy required; MS Office skills (Outlook, Word, Excel, PowerPoint).
Travel:
- Must be willing to travel approximately 10%.
- Ability to work on a computer for extended periods of time.
Summary:
The Utilization Review Nurse is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services “CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and guidelines related to UM. This nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS.
Responsibilities:
- Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
- The prior authorization role completes an assessment of a proposed service to determine if the beneficiary has eligible coverage for the service and if it is medically necessary.
- Promote quality, cost-effective outcomes through prior authorization and concurrent review of requested services for medical necessity based upon evidence-based clinical guidelines.
- Identify and present cases of possible quality of care deviations, questionable admissions, and prolonged lengths of stay to the Medical Director for further determination.
- Appropriately refer beneficiaries who have complex or chronic conditions, a need for transition of care, disease management support, or other identifiable needs for coordination of the beneficiary’s member’s health care for behavioral health care management.
- Follow CHRISTUS Health Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent, or detect unauthorized disclosure of Protected Health Information (PHI).
- Protect the confidentiality of data and intellectual property; assures compliance with national health information guidelines.
- Analyze clinical information submitted by medical providers to evaluate the medical necessity, appropriateness, and efficiency of the use of medical services, procedures, and facilities.
- Perform provider outreach to address post-hospital discharge services, redirection to in-network providers for appropriate steerage, durable equipment usage, and utilization of other medical services and/or procedures and other necessary telephonic follow-up.
- Utilize the nursing process and critical thinking skills to provide oversight of services and evaluation of service options.
- Ability to work in a variety of settings with culturally diverse communities with the ability to be culturally sensitive and appropriate.
- Must have excellent communication skills (written and verbal), clinical judgment, initiative, critical thinking, and problem-solving abilities.
- Must be able to take after hour calls to meet business requirements as needed.
Job Requirements:
Education/Skills
- Graduate of an accredited school of vocational nursing or equivalent required
- Associate’s (ADN) or Bachelor’s (BSN) in Nursing preferred
Experience
- 3 – 5 years of nursing experience preferred
- Experience in Microsoft software (e.g., Outlook, Teams, Word, and Excel) required
- General computer knowledge and capability to use computers required
Licenses, Registrations, or Certifications
- LVN license in the state of employment or compact required
- RN license in state of employment or compact preferred
Work Schedule:
5 Days - 8 Hours
Work Type:
Full Time
$26.61 - $39.92 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Quality Review Sterile Processing Tech ? Sterile Processing -Mid shift
Position Highlights:
- Position: Quality Review Sterile Processing Tech
- Location: Elmhurst, IL
- Full Time/Part Time: Full time
- Hours: Monday-Friday, 12:00noon-8:30pm, must be flexible to travel to other Endeavor Health locations.
What you will do:
- Ensures daily operational compliance with the standards governing sterile processing activities from such agencies as The Joint Commission, OSHA, AORN, AAMI; as well as state and local ordinances
- Assists in coordination, facilitation and monitoring of new and existing sterile processing staff education, training and orientation via one-on-ones, huddles, staff meetings, in-services and formal orientation in collaboration with department leadership
- Assists with the maintenance, inventory, and implementation of newly acquired and existing instrument trays/sets, instruments, and supplies
- Collaboratively works with the appropriate staff to maintain accurate instrument count sheets and make revisions as necessary
- Provides analysis of reported data and recommendations for improvement
- Assists with identification of staff educational needs and development of programs
What you will need:
- Education: Highschool or GED required, Bachelors Degree Preferred
- Certification: Certified Sterile Processing and Distribution Technician (CSPDT) - Certification Board for Sterile Processing and Distribution (CBSPD) or Certified Registered Central Service Technician (CRCST) ? Healthcare Sterile Processing Association (HSPA), formerly IAHSCMM)
- Experience: 2 years? experience in health care sterile processing (or procedural area) and environment AND experience in project management and staff education
Benefits (For full time or part time positions):
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, Pet and Vision options
- Tuition Reimbursement
- Free Parking
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off and Holiday Pay
- Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to ?help everyone in our communities be their best?.
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
The Utilization Review Physician collaborates with the healthcare team in the management and resolution of activities that assure the integrity of clinical records for the patient population and Hackensack University Medical Center.
These include but are not limited to utilization review, hospital reimbursement, clinical compliance, case management, and transitions of care, as outlined in the responsibilities below.
Education, Knowledge, Skills and Abilities Required: 1.
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.
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.
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.
By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.
Job Title: Health Service Reviewers (RN)
Pay (openings for each location/market):
- Albany up to $52/hr
- Central Islip up to $60/hr
Overview: These RNs will be doing a mix of standard quality audits, complaint initiated investigations, and more. When they are onsite, the amount of time that they are at the location is dependent on the audit that is required. It is expected that Health Service Reviewers will be traveling onsite about 85% of the time.
These individuals will be traveling to IDD housing to do state required Recertification (must be done every 15 months) or investigating specific complaints (disease outbreak, falls, etc.).
Travel: 85% of this role is traveling to sites. It is more location based and they will be traveling to the counties that surround their location. If anyone is traveling and not able to return home, they are able to coordinate accomodations through the travel office and miles/food will be reimbursed at the federal rate. If they are not onsite, they can work from home or in the DOH office.
Summary: Based in NY, working at the direction of the New York State Department of Health (NYSDOH), Office of Aging and Long-Term Care, this individual will conduct surveillance and investigation activities related to Intermediate Care Facilities for Intermediate Care facilities for Individuals with Intellectual Disabilities (ICF/IDD). Duties include but are not limited to participating in surveys or complaint investigations, document finding, draft Statement of Deficiencies (SOD) within specified timeframes, testifying in administrative hearing ad needed.
The position is majority travel and will be onsite at facilities.
Qualifications:
- Strong interpersonal skills with the ability to communicate professionally with colleagues, supervisors, providers, medical and administrative personnel and residents/patients.
- Excellent communication (verbal & written) skills.
- Ability to work independently with minimal supervision.
- Ability to relate effectively to clinical and administrative personnel and patients.
- Computer proficiency with the ability to learn and understand new review programs and monitoring tools.
- Able to travel to on-site facility within New York State, required.
- Must have a valid driver's license & the ability to travel to on-site facilities review assignments.
Education/Experience:
- Registered Professional Nurse (RN). Currently licensed and registered in New York State, required.
- Bachelor’s degree, in any health care related field.
- Two (2) years clinical experience with individuals with intellectual disabilities or in developmental disability facilities and deemed QIDP (Qualified Intellectual Disability Professional and ability to meets the federal requirements for attaining QIDP Certification with six (6) months of hire date.
Hours: Monday-Friday 8am-5pm
Insight Global is seeking Technical Evaluation Review Board/CCB Coordinator to join our team for an exciting opportunity to work on a unique government contract. The contract assists in acquisition and technical sustainment engineering and will augment government resources. The coordinator manages government technical review board submissions, ensuring all programs meet required deliverables and are fully prepared for review before board meetings. They control document accuracy, track changes, and maintain compliant review packages across all stakeholders. The role requires confidently driving engineers and IPTs to meet requirements and deadlines, including pushing back when inputs are incomplete. This is a highly organized, assertive position focused on accountability, readiness, and execution.
Must Haves:
- BS/MS in engineering/specialty area
- 7 yrs directly related experience (5 yrs with MS degree)
- Active secret level security clearance or higher
- Strong planning, coordination, and organizational skills with the ability to manage multiple priorities
- Demonstrated experience developing, maintaining, and assessing technical baselines within controlled programs
- Familiarity with engineering standards, manufacturing methods, and configuration management practices, including military and ASME-guided environments
- Working knowledge of technical drawing conventions and engineering documentation controls
- Proficiency with Microsoft Office tools to prepare data-driven reports, metrics, and formal documentation
- High attention to detail, strong writing and verbal communication skills, and the ability to manage time effectively
- Ability to sit on-site at Hill AFB in Clearfield, UT Monday-Wednesday
Plusses:
- Experience supporting configuration and data management activities within a defense or government program environment
- Working knowledge of Air Force or DoD engineering release processes, configuration control standards, and technical documentation lifecycle management
- Familiarity with Engineering Change Proposals (ECPs), Interface Control Documents (ICDs), and associated revision and audit activities
- Prior involvement with functional and physical configuration audits, including coordination with suppliers or government facilities
- Training or certification in configuration or data management disciplines (e.g., CMPIC or similar)
- Demonstrated ability to maintain and protect complex engineering baselines for hardware and software systems
- Strong judgment and decision-making skills aligned with regulatory, contractual, and policy requirements
- Commitment to continuous learning and maintaining up-to-date technical proficiency
This role is responsible for conducting detailed clinical reviews, evaluating medical necessity, and ensuring compliance with applicable regulatory requirements and organizational policies.
The Clinical Review Nurse will collaborate with internal teams and medical leadership to ensure timely and accurate resolution of cases while maintaining high standards of care and service.
Key Responsibilities for Clinical Review Nurse Conduct investigations and clinical reviews of member and provider grievances and appeals related to medical necessity .
Review prospective, inpatient, and retrospective medical records associated with denied services.
Summarize and present medical findings for Medical Directors, consultants, and external reviewers .
Apply clinical guidelines, policies, and benefit plan documentation when evaluating cases.
Prepare recommendations to uphold or overturn determinations and submit to the Medical Director for final approval.
Ensure appeals, grievances, and disputes are resolved within required regulatory timelines .
Evaluate requests for expedited review and determine urgency criteria.
Document case details and maintain accurate records within relevant tracking systems.
Draft written correspondence for members, providers, and regulatory entities .
Communicate with members, providers, and internal staff to support resolution of clinical concerns.
Identify potential quality-of-care concerns and escalate appropriately.
Serve as a clinical resource and subject matter expert to assist team members with appeals and grievance resolution.
Participate in additional projects and duties as assigned.
Essential Functions for Clinical Review Nurse Conduct thorough investigations of appeals, grievances, and provider disputes .
Evaluate the appropriateness of care within contractual, regulatory, and accreditation standards.
Identify system or process issues that may impact member care or service expectations and recommend improvements.
Perform documentation, reporting, and analytical tasks related to case reviews.
Maintain compliance with organizational policies, regulatory requirements, and professional standards .
Minimum Qualifications for Clinical Review Nurse Education / Licensing Active and unrestricted California Registered Nurse (RN) license Bachelor’s degree preferred Experience for Clinical Review Nurse Minimum 3 years of acute care clinical experience Minimum 2 years of appeals and grievances casework Preferred Experience for Clinical Review Nurse Utilization Management or Quality Management Experience applying standardized clinical guidelines Familiarity with Milliman Care Guidelines (MCG) , Managed Care, and NCQA standards Additional Details for Clinical Review Nurse No direct supervisory responsibilities Collaborative role working with clinical, operational, and leadership teams If you are an experienced nurse with strong clinical review and case evaluation skills and are looking to contribute to a team focused on quality care and regulatory excellence, we encourage you to apply.
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