Quality Utilization & Case Review Specialist
Texas Family Care Network
Texas Family Care Network is seeking an Utilization Management & Case Review Specialist to conduct utilization reviews, case record reviews, and quality assessments supporting compliance and service quality. You will analyze utilization patterns, review documentation for accuracy, identify risks, and collaborate with providers to drive continuous improvement. Responsibilities include monitoring service trends, ensuring alignment with contracts, applying review tools, and supporting audits. #J-18808-Ljbffr Texas Family Care Network
- ...Locations Showing 1 location Description Position Summary The Utilization Management & Case Review Specialist is responsible for conducting utilization reviews, internal case record reviews, and quality assessments to support compliance, service quality, and positive...QualityFull timeFor contractorsWork at officeLocal areaNight shift
- ...AMLI Residential is seeking an Applicant Review Specialist to join our Resident Services Group at... ...trends related to fraud, application quality, and approval rates. Prepare reports and... ...for all employees. The Company may utilize artificial intelligence, as permitted by...QualityWork at officeLocal area
- A leading healthcare staffing firm is seeking a Utilization Review RN in Syracuse, NY. The role involves conducting utilization management activities, certification reviews, and collaborating with healthcare providers. Candidates must have an RN License in NY and at least...SuggestedMonday to Friday
$136.24k
...costs for these take‐offs. Utilizes Timberline to prepare or assists... ...estimates. Receives, reviews and files pricings received from... ...junior staff. Develops the Quality Control Plan (QCP) for review.... ...country statutory law but in no case, will the background check precede...QualityContract workWork experience placementFor subcontractorH1b- ...committed to our core values of quality, compassion, and community!... ...and completes the clinical reviews for all patient medical records... ...Actively participates in the Case management and UR meetings.... ...accounts for multiple levels of Utilization Review and Case Management...QualityLocal area
- ...&T Program Purchasing Specialist within our team who will... ...material design review practice. Drive Supplier... ...single and sole source cases. Implement inbound logistics... ...can meet the service, quality and cost requirements.... ...KPI monitoring and utilization follow-up. SAP...QualityWork at officeRemote work
- The Family Engagement Specialist works under the direct... ...Conferences (FGC), Single Case Plan Meetings, Circles... ...children involved. Utilizes effective time... ...Assists case managers with reviewing case records to identify... ...maintain unit operations. Quality Improvement Prepare...QualityWork at officeShift work
- ...We are seeking a Permit Specialist who researches, prepares, submits... ...coordinates with agencies, utilities, vendors, and internal teams... ...are completed accurately, reviewed efficiently, and approved on... ...customer service, SLA compliance, quality assurance, and timely project...QualityTemporary workFor subcontractorRemote workMonday to FridayShift work
- ...not limited to, the following : Manage all aspects of utility onboarding and other utility matters Update utilities database... ...to consistently meet goals and deadlines without sacrificing quality Exhibits sound judgment and decision-making ability...QualityFull timeWork at officeLocal areaFlexible hoursAfternoon shift
$63 per hour
...roads, dams, bridges, facilities, utilities, etc.) to verify compliance... ...and any needed sampling. • Review contractor submittals, RFIs, shop... ...to safety, environmental, quality control, and permitting requirements... ...statutory law but in no case, will the background check precede...QualityContract workFor contractorsWork experience placementH1bImmediate startOverseasFlexible hours- ...Title: Intake and Placement Specialist Job Category: Provider Management Requisition... ...intense level of care. Work involves reviewing placement applications for sufficiency and quality of information. The position interacts with Case Managers and placement providers to...QualityFull timeWork experience placementWork at office
$2,150 per week
...AMN Healthcare Revenue Cycle is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Syracuse, New York. Job... ...influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare...QualityTemporary workZero hours contractImmediate startShift work$25.39 per hour
...mill and load the day’s programs. You’ve reviewed the prints, verified the G/M-code, and... ...maintenance, and huddle with engineering and quality to keep delivery on track. Before... ...production records, inspection logs, and utilization reports Follow HSE policies rigorously...QualityHourly payPermanent employmentImmediate startAfternoon shift- ...seeking an experienced FF&E Specialist with 3-5 years of professional... ...detail required to deliver high-quality projects.The ideal candidate... ..., dealer coordination, bid review and leveling, substitutions,... ...state, or local law. In some cases, local laws and regulations may...QualityFull timeFor contractorsLocal areaFlexible hours
- ...technology companies. As a BIM Specialist, you will collaborate with... ...level contact for BIM content review, approval, management, and maintenance... ...for data center projects, utilizing professional tools and... ...with a focus on delivering high-quality work and continuous...QualityFull timeFlexible hours
$154.2k - $328.4k
...candidates for our open Placement Specialist position. This is a hybrid... ...activities and delivery of reviewed policy to client and helps address... ...colleagues to deliver a high-quality experience through clear... ...Decisions will be determined on a case-by-case basis. In addition to...QualityMinimum wageWork at officeLocal areaImmediate startRemote workFlexible hours3 days per week1 day per week- ...and manufacturing of new products, improve quality, ensure compliance, reduce time to market... ...companies and government agencies utilize.What would you do? Deliver exceptional, differentiated... ...requirement specifications, use cases, user stories, and design documentsOperate...QualityFull timeLive inWork at officeLocal area
$88k - $125k
...Job Description Mechanical Specialist Openings: Multiple About... ...project delivery. Review drawings, specifications, sequences... ...to safe, reliable, and high-quality project execution in a fast-paced... ...lifecycles, and reduce utility costs. This dedication has earned...QualityFull timeFor contractorsFor subcontractorLive outWork at officeImmediate startRemote workFlexible hours- ...Title & Specialty Area: Patient Safety Specialist Department: Quality Patient Safety Location: Children... ...and facilitates the investigation, review and disposition of patient safety... ...medical record and literature reviews and utilization of appropriate investigative tools....QualityFull timeWork experience placementMonday to FridayShift work
$21.63 per hour
...Housing Specialist Liberty Resources is seeking a Housing Specialist... .... We pride ourselves on high quality, integrated, community-based... ...Housing Specialist performs case management-related functions... ...placement, ongoing rental and utility assistance for residents....QualityPermanent employmentLocal area- ...CDI SpecialistThe CDI Specialist reviews inpatient medical records to ensure clinical documentation... ...impacts reimbursement accuracy, quality reporting, and patient outcomes.Job Responsibilities... ...and support quality metrics, including case mix index (CMI), hospital-acquired...QualityWork at office
$54.46k - $81.55k
...Production Specialist US-TX-Irving Job ID: 34559 Type: Full... ...forecasting thru salesforce.com. - Utilize Workplace Technologies &... ...unparalleled reputation for quality and innovation.... ...veteran status. If you are not reviewing this job posting on our Careers...QualityFull timeFor contractorsFor subcontractorCasual workWork at officeLocal area- ...looking for a Self-Driving Systems Specialist to support the diagnostics,... ....Escalate complex technical cases to engineering teams with... ...according to strict safety, quality, and technical procedures.Software... ...downtime.Support incident reviews, root-cause analysis, and technical...QualityWork at office
- ...career as a(an) Patient Access Specialist today with Texas Joint... ...practice management tool/EMR Utilize appropriate system to communicate... ...patients looking for high-quality healthcare within the HCA Healthcare... ...opening. We promptly review all applications. Highly qualified...QualityFull timeTemporary workWork at officeMonday to FridayFlexible hoursDay shift
$29.54 per hour
...execute accurate patient record merges. Review and approve MyChart proxy and access requests... ..., guardians, and incapacitated adults. Utilize Epic, Care Everywhere, and other... ...record issues while meeting productivity and quality expectations. Qualifications & Skills High...QualityHourly payPermanent employmentContract workTemporary workWork experience placementShift work$19.8 - $24.4 per hour
...Bankruptcy Specialist At Exeter Finance, we are committed to helping... ...account records, monitoring case activity, and ensuring... ...accounts. Job Duties: Review, analyze, and process bankruptcy... ...established service levels, quality standards, and legal requirements...QualityHourly payWork experience placementWork at office- ...maintains tools to enhance estimating and the utilization of Company resources in generalKEY DUTIES AND RESPONSIBILITES:Reviews, evaluates and/or validates cost estimates... ...work groups to develop, maintain and improve quality of estimating and scheduling processes and tools...QualityHourly payContract workWork experience placementImmediate start
- ...MEP Specialist / Lead Electrical Superintendent The MEP Specialist... ...field teams to ensure safety, quality, and on-time delivery.... ...regular construction meetings to review progress, issues, and upcoming... ...maintain a comprehensive Site Utilization plan to optimize logistics, material...QualityContract workTemporary workFor subcontractorWork at office
$20 - $24 per hour
...and motivated Part Time Peer Specialist to work in our Onondaga Crisis... ...Peer Support Services utilizing individuals with a history of... .... We pride ourselves on high quality, integrated, community-based... ...direct care and support services, case management, medication management...QualityHourly payPart timeWork experience placementWork at officeLocal areaWork from homeNight shift- ...Job Title: Driver Onboarding Specialist Department: Driver... ...Run/Report Tracking: Utilize tracking systems and software... .... Conduct periodic safety reviews and refresher courses for experienced... ...promoting safety, maintaining high-quality standards, and delivering...QualityFull timeImmediate start
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