Search Results: 8,440 vacancies
...Optimization Platform. Offering a strong foundation with deep roots in clinical and member advocacy, alongside decades of expertise in claim... .... About our Opportunity:
As the Clinical and Bill Review Advisor at Valenz Health, you will play a pivotal role in guiding...
Suggested
Holiday work
Immediate start
Remote job
Flexible hours
...core to our business.
Join Evolent for the mission. Stay for the culture.
**What You'll Be Doing:**
As a Oncology, Physician Clinical Reviewer you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in...
Suggested
...well. We do not lose sight of that. It fuels our passion and drives every decision we make.
**Job Posting Title**
Physician Clinical Reviewer- GI- REMOTE
**Job Description Summary**
Key member of the utilization management team, and provides timely medical review of...
Suggested
Remote job
Work experience placement
Internship
Local area
...live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
Job Posting Title
Clinical Review Pharmacist
The Clinical Staff Pharmacist is responsible for the processing and documenting of Utilization Management requests...
Suggested
Holiday work
Local area
Visa sponsorship
Work visa
Weekend work
...the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene... ...of medical care.
+ Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness...
Suggested
Holiday work
Remote job
Flexible hours
As the Clinical and Bill Review Advisor, you will play a pivotal role in guiding and advising on our internal clinical and bill review processes. Your expertise and insights will be crucial in informing strategic decisions and enhancing operational efficiencies.
What...
Suggested
Holiday work
Full time
Immediate start
Remote job
Flexible hours
...Phoenix Medical Psychiatric Hospital is looking for a Utilization Review Coordinator to coordinate patients services across the... ...needed.
Initial Precertification with payors.
Concurrent Clinical review with payors.
Document in the electronic system daily...
Suggested
..., Retrospective UM. Supervises staff who conduct retrospective review of medical claims for appropriate DRG or non-DR coding and processing... ...(CCS) or Certified Professional Coder (CPC)
•2+ years of clinical experience
•2+ years coding experience
•2+ years...
Suggested
Remote job
Contract work
Temporary work
Local area
Shift work
...As a Valleywise Utilization Review RN Coordinator, you are part of a multidisciplinary team providing exceptional care to our patients... ...the acute care medical hospital. This requires proficiency in clinical criteria, evidence-based practice, regulatory compliance, reimbursement...
Suggested
Hourly pay
...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...
Suggested
Holiday work
Full time
...a part of the #1 full truckload carrier in the nation. Be a part of Swift Transportation.
Job Responsibilities: What you will do
Review violations, log and follow up to ensure compliance.
Are to include but are not limited to the following, other duties may be assigned...
Suggested
Local area
...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....
Suggested
Contract work
...Responsibilities
Utilization Review (UR) Coordinator Opportunity.
Position: PRN (as needed)
This position is on-site and... ...an intensive outpatient program (IOP). We also have a satellite clinic offering Intensive Outpatient Programs in the West Valley region...
Suggested
Relief
Local area
Remote job
...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...
Suggested
Holiday work
Full time
Contract work
Casual work
Local area
Shift work
Monday to Friday
...Description For Value-Based Care (VBC) programs within HOPCo Clinically Integrated Networks (CINs), promotes adherence to evidence-based... ...experience is required
Orthopedic experience required.
Clinical review, utilization review, or quality assurance review experience...
Suggested
Part time
$35.42 - $48.44 per hour
...based, training and development programs including new employee orientation, preceptor training, facility specific in- services, and clinical, quality, and customer service training programs to promote quality patient care, and achieve Area, Regional and/or Enterprise-...
Full time
Night shift
$36.46 - $49.48 per hour
...About this role: As a Clinical Manager with Fresenius Medical Care, you will ensure that quality patient care is delivered while maintaining... ....
Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding.
Manages...
Full time
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...
Remote job
Hourly pay
Full time
Flexible hours
...Summary:
The Registered Nurse will utilize standard criteria to review post-service and prepayment reviews of Outpatient Behavioral... ...Medicaid requirements.
Responsibilities:
Performs clinical/medical reviews of retrospective medical claim reviews, medical...
Local area
Remote job
...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
