...coding staff to ensure contractual compliance. Reports to the Manager, Retrospective UM. Supervises staff who conduct retrospective review of medical claims for appropriate DRG or non-DR coding and processing. Performs independent research and in-depth evaluation of...
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...ensure better access to our unique model of care.
Overview:
Phoenix Medical Psychiatric Hospital is looking for a Utilization Review Coordinator to coordinate patients services across the continuum of care by promoting effective utilization, monitoring health...
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...owned community bank and one of Prairie Business Magazine's 50 best places to work for 10 years running. We are looking for a Credit Review Associate who can clearly identify borrower risk and translate the risk factors into terms others can understand within a narrative...
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Full time
...drives every decision we make.
Job Posting Title
Clinical Review Pharmacist
The Clinical Staff Pharmacist is responsible... ...of the decision as it pertains to the clinical content of the case and the intent of the individual client’s pre-approved criteria...
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Visa sponsorship
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...Role: Penalty Review Specialist-1276
Estimated Duration: 6+ months
Location: Phoenix, AZ (hybrid)
Position Description
Primary Duties:
Analyze applicant data for abatement consideration.
Request additional information when needed....
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...FT 36 Hours Per Week
Shifts: Mid
As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing... ...of recent acute clinical RN hospital experience, preferably in Case Management and/or Utilization Management.
Specialized Training...
Suggested
Hourly pay
Shift work
...decision we make.
Job Posting Title
Physician Clinical Reviewer- GI – REMOTE
Summary
Key member of the utilization... ...following utilization management functions:
+ Reviews all cases in which clinical determinations cannot be made by the Initial...
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...**What You'll Be Doing:**
As a Oncology, Physician Clinical Reviewer you will be a key member of the utilization management team. We... ...Doing:**
+ Serve as the specialty match reviewer in Oncology cases, that do not initially meet the applicable medical necessity guidelines...
Suggested
...meets all Federal and State requirements.
+ Ensure second-level reviews have been performed and documented and may confer with medical... ...Preferred Qualifications:
+ Managed care experience
+ Case management experience
+ Experience with appeals and/or denials...
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Full time
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Monday to Friday
...Role: Purchase Reviewer-1153
Estimated Duration: 6+ months
Location: Phoenix, AZ
Position Description
The purpose of this position is to provide support to constituents, including education administrators and staff, community members, education partners...
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...members, Valenz engages early and often for smarter, better, faster healthcare. About our Opportunity:
As the Clinical and Bill Review Advisor at Valenz Health, you will play a pivotal role in guiding and advising on our internal clinical and bill review processes....
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Full time
Immediate start
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Flexible hours
...Job Description
Job Description Position Description: The Case Manager II position is responsible for engaging UMOM's clients to... ...unique needs and circumstances and regularly meet to discuss and review progress.
Meets regularly and consistently with your client...
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Local area
Immediate start
Night shift
Monday to Friday
...team members. The will participate and provide feedback to the team for regular interdisciplinary group meetings; on the development, review and revision of the patient/family plan of care.
**If you feel as called as we do to make a difference in the journey of HOSPICE...
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Relief
...Experienced Document Review Attorney – Remote
Great opportunity for l icensed attorneys with document review experience interested in quality focused e-Discovery. We have some projects anticipated to start soon and others in the pipeline. Please apply to get on...
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...appropriate medical team to promote quality and cost effectiveness of medical care.
+ Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
+...
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Overview:
Shift: Tuesday- Saturday 6AM-2PM
Community Medical Services (CMS) is urgently hiring a Case Manager to help individuals suffering from addictions to opioids and other illicit substances gain access to care. Every day, under the direct supervision of...
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Work experience placement
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Trial period
Shift work
Saturday
...required
Bachelor’s degree in nursing preferred
Minimum three (3) years of clinical nursing and/or Care Management experience is required
Orthopedic experience required.
Clinical review, utilization review, or quality assurance review experience preferred...
Part time
...motivated, energetic and independent registered nurse to fill a Medical Case Manager position in Arizona.
Work from home, and on the road.... ....
A cost containment background, such as utilization review or managed care is helpful.
Strong interpersonal, time management...
Minimum wage
Full time
Local area
Work from home
Flexible hours
Night shift
Monday to Friday
...Custard Insurance Adjusters, Inc.
Property Claims Reviewer/QA
Phoenix, AZ
We are growing our company and looking for highly skilled team members to grow with us! We are looking for motivated individuals who are passionate about quality work and providing superior...
Full time
Remote job
Work from home
Flexible hours
Monday to Friday
...responsible for the coordination of all aspects of the underwriting, case management, and implementation process for new business. This... ...successful completion
•Coordinate ordering of APS records and review records upon receipt
•Write detailed cover letters to...
...Job Description
Job Description
General Purpose
To review and bill Loss Control Inspections and ensure they meet Afirm/Davies quality control standards, customer specific requirements, and industry standards.
Essential Duties and Responsibilities:
~ Reviews...
For contractors
Remote job
...DC, WI & WY only)
This leader will report to the Manager of Case Management Special Programs under the overall Case Management... ...timeliness, and process consistency. Conducts regular and ad hoc case review audits, providing staff feedback regarding results and process...
Remote job
Full time
Temporary work
Interim role
Local area
Shift work
...and desktop monitor, mileage and travel reimbursement, Employee Assistance and Referral Program, and hands-on workers compensation case management training.
Join ou r compassionate team and help make a positive difference in an injured persons life. As a Telephonic...
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Full time
Part time
Home office
Flexible hours
...individualized services to support our members independence and recovery goals. Our jobs offer stability, flexibility, and community!
The Case Manager, as a member of the clinical team, completes assessments and service plans and implements services to consumers in...
Hourly pay
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Full time
Temporary work
Local area
...Immigration Services Location: Phoenix, Arizona Position Type: Regular Date Reviewed: March 2024 General Description:
In concert with the Resettlement Supervisor, Intensive Case Management team and Employment
Team, the Case Manager I will provide direct core...
Hourly pay
Permanent employment
Temporary work
Local area
Immediate start
...abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive...
Full time
Remote job
Flexible hours
...Job Description
Job Description
Position: Behavioral Health Case Manager
Location: Phoenix, AZ (Onsite)
Employment Type: Contract (Full-time)
Company: LHH Recruitment Solutions
Job Description: LHH Recruitment Solutions is currently hiring a Case...
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Full time
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For contractors
Local area
Immediate start
Currently hiring
$17 - $20 per hour
...Network has partnered with a national law firm looking to hire a Case Manager to join their team. Our client is looking to bring on... ...Responsibilities:
Correspond regularly with clients to request and review documentation related to the case
Communicate via phone call,...
Remote job
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...TOP RESPONSIBILITIES
You will be responsible for conducting case management assessments on community, shelter and program clients... ...progress towards achieving service plan goals, conducts regular plan reviews and adjusts as necessary.
You will lead or participate in...
Holiday work
$49k - $51k
...experienced and highly motivated individual to join our team as a Case Manager 2. DDD provides individuals with developmental... ...relationships and to discuss service needs and supports.
Develop, write, review, monitor and evaluate Individual Support Plan (ISP) in...
Holiday work
Full time
Temporary work
Flexible hours
