Nursing and Care Specialist

2 weeks ago


Dover, Kent, United Kingdom Intermountain Healthcare Full time

Job Title: Clinical Reviewer for External Audits

Job Description:

We are seeking a highly skilled Clinical Reviewer for External Audits to join our team at Intermountain Healthcare. As a key member of our utilization review team, you will be responsible for reviewing governmental contractors' response letters and medical records to determine the viability of appeals.

About the Role:

The ideal candidate will have a strong understanding of federal regulations, law, and relevant CMS policies, as well as excellent clinical judgment and communication skills. You will research and apply these regulations to support appeals, communicate with stakeholders regarding missing or insufficient medical documentation, and ensure timely completion of data entry in audit databases.

Responsibilities:

  1. Review and Analysis: Conduct thorough reviews of governmental contractors' response letters and medical records to determine the viability of appeals.
  2. Communication: Communicate effectively with stakeholders regarding missing or insufficient medical documentation.
  3. Research and Application: Research and apply federal regulations, law, and relevant CMS policies to support appeals.
  4. Data Entry: Ensure timely completion of data entry in audit databases.

Requirements:

  • Bachelor's Degree: Bachelor of Science in Nursing (BSN) preferred.
  • Licensure: Current licensure as a registered nurse in state of practice.
  • Experience: Three (3) years of experience in utilization review or care management, hospital insurance billing, third-party claim audits, or auditing in a healthcare setting.

Compensation and Benefits:

This role offers an estimated salary of $54.53 per hour, making it an attractive opportunity for nursing professionals looking to advance their careers. We also provide a comprehensive benefits package, including health, dental, and vision insurance, 401(k) matching, and paid time off.



  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Join Our Team as a Dental Nursing SpecialistWe are looking for an experienced Dental Nurse Specialist to join our team at Bupa Dental Care. As a key member of our dental nursing team, you will be responsible for delivering high-quality patient care and supporting the clinical team in the delivery of dental services.Your Key Responsibilities:Supervise and...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Dental Nurse Position at Bupa Dental CareWe are seeking a highly skilled and dedicated Dental Nurse to join our team at Bupa Dental Care. As a Dental Nurse, you will play a vital role in delivering exceptional patient care and contributing to the success of our dental practice.Key Responsibilities:Assist dentists and hygienists during proceduresPrepare and...


  • Dover, Kent, United Kingdom NHS Full time

    Job DescriptionWe are seeking a dedicated and experienced Nurse Leader to join our Community Nursing Team based along the South Kent coast.This is an excellent opportunity to work with a highly skilled and compassionate team, delivering high-quality care to patients in their own homes. As a Senior Community Nursing Specialist, you will be responsible for...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    We are seeking a dedicated and compassionate Clinical Nursing Supervisor to join our team at Bupa Dental Care. As a key member of our clinical team, you will be responsible for providing exceptional patient care and supervising a team of dental nurses.About the Role:This is a full-time position, working Monday to Friday, 40 hours per week.The successful...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Dental Care Team Leader Job Description:Bupa Dental Care is looking for a highly motivated and experienced Lead Dental Nurse to lead our dental nursing team in Dover. As a key member of our team, you will be responsible for delivering high-quality patient care and contributing to the success of our practice.Key Responsibilities:Lead a team of dental nurses...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    About the Role:We are seeking an experienced Lead Dental Nurse to lead our dental nursing team in Dover. As a key member of our team, you will be responsible for delivering high-quality patient care and contributing to the success of our practice.Key Responsibilities:Lead a team of dental nurses in providing high-quality patient care.Ensure that all clinical...

  • Primary Care Nurse

    1 week ago


    Dover, Kent, United Kingdom Bupa Dental Care Full time

    Career OpportunityBupa Dental Care is hiring a talented Dental Nurse for our Dover location. This role involves working Monday to Friday, 40 hours a week, with opportunities for career advancement.We provide a comprehensive benefits package, including GDC registration, DBS check, and professional indemnity coverage, ensuring our employees' professional and...


  • Dover, Kent, United Kingdom Pulse Nursing Full time

    Lead Nurse Opportunity:Pulse Nursing has an exciting opportunity for a Lead Nurse to join our team in Dover, leading the delivery of community blood tests. As a clinical leader, you will oversee the daily delivery of quality care, ensuring compliance with clinical governance and targets.The successful candidate will provide clinical leadership to Healthcare...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Job DescriptionDental Nurse - Dover: A Rewarding Career OpportunityWe offer a competitive salary of £28,000 - £35,000 per annum, depending on experience.You will be working Monday to Friday, 40 hours a week, with the security and stability that comes with being part of Bupa Dental Care. Your GDC registration, DBS check, and professional indemnity are all...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Job Overview:Bupa Dental Care seeks a highly skilled Lead Dental Nurse to join our team in Dover. As a key member of our dental nursing team, you will play a vital role in ensuring the delivery of exceptional patient care and contribute to the success of our practice.Estimated Salary: £35,000 - £42,000 per annum.Key Responsibilities:Lead a team of dental...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    About the RoleWe are seeking a skilled Dental Nurse to join our team at Bupa Dental Care. As a key member of our clinical support team, you will be responsible for providing exceptional patient care and supporting our dental professionals in delivering high-quality treatment.


  • Dover, Kent, United Kingdom Cenetene Corporation Full time

    Care Coordination Specialist - Are you a compassionate and detail-oriented Registered Nurse looking for a new challenge? We invite you to join our team as a Nurse Care Coordinator at Centene Corporation.In this role, you will work closely with our healthcare team to develop and implement care plans that meet the unique needs of each member. Your...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Bupa Dental Care: Join Our Team as an Oral Healthcare Support Specialist\We are looking for a highly skilled and dedicated individual to fill the role of Oral Healthcare Support Specialist at Bupa Dental Care. As a valued member of our dental care team, you will contribute to delivering high-quality patient care and supporting the success of our...

  • Nurse Care Manager

    2 weeks ago


    Dover, Kent, United Kingdom Cenetene Corporation Full time

    Care for 28 million members and make a difference in their lives. Centene Corporation, a leading diversified health organization, offers a unique opportunity to join our team as a Nurse Care Coordinator. This role is perfect for individuals who are passionate about delivering high-quality, cost-effective healthcare outcomes.We are seeking a dedicated and...

  • Nurse Specialist

    3 weeks ago


    Dover, Kent, United Kingdom Sanctuary Personnel Ltd Full time

    Job Overview:We are seeking a highly skilled Nurse Specialist to fill a locum contract in Dover. As a General Nurse, you will play a vital role in providing quality care to patients, working closely with our team to ensure seamless delivery of services.Key Duties:Your responsibilities will include dressing, baby immunisations, and depo's as a priority,...


  • Dover, Kent, United Kingdom NHS Full time

    About the RoleWe are seeking a talented and experienced Nurse Leader to join our Community Nursing Team based along the South Kent coast.The successful candidate will be responsible for supervising and leading a team of community nurses, ensuring they deliver high-quality care to patients in their own homes. You will work closely with our Primary Care...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Job Title: Dental Nursing Team LeaderAbout the Role:We are seeking an experienced Lead Dental Nurse to join our team at Bupa Dental Care. As a key member of our dental nursing team, you will play a vital role in providing exceptional patient care and contributing to the delivery of high-quality dental services.Key Responsibilities:To lead and supervise a...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    At Bupa Dental Care, we are seeking a highly skilled Dental Nurse Manager to join our team in Dover.The successful candidate will have the opportunity to work on a fixed-term contract for 24 months, working Monday to Friday with a total of 40 hours per week.We are committed to providing a supportive environment where our people can thrive. As a Dental Nurse...


  • Dover, Kent, United Kingdom Bupa Dental Care Full time

    Dental Nurse Role OverviewWe are seeking an experienced and skilled dental nurse to join our team at Bupa Dental Care in Dover. As a dental nurse, you will be responsible for providing high-quality patient care and supporting the dentists during clinical procedures.Key Responsibilities:Set up decontamination of instruments and maintain a clean and safe...


  • Dover, Kent, United Kingdom Pulse Nursing Full time

    About the Role:We are looking for a skilled Healthcare Service Delivery Specialist to lead our community blood tests team in Dover. As a Service Delivery Lead, you will be responsible for overseeing the daily delivery of quality care, ensuring compliance with clinical governance and targets.The successful candidate will provide clinical leadership to...