Average salary: $51,500 /yearly
More statsSearch Results: 29,385 vacancies
...appropriateness of admissions and continued stays, and documents findings based on Departmental standards.
• While performing utilization review identifies areas for clinical documentation improvement and contacts appropriate department.
• Identifies at-risk populations...
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Shift work
...JOB PURPOSE:
Under the direction of the Senior Director of Clinical Review, the Clinical Review Nurse is responsible for complying with the day-to-day operations of the Clinical Review Department. Responsibilities include reviewing, recommending and providing authorization...
Suggested
Flexible hours
...initiatives that support best case practice agency wide.
The Medical Review Authorization and Monitoring Unit (MRAM) reviews foster care... ...medical treatment when parent/legal guardian objects.
The Nurse Reviewer will participate in all medical record reviews /audits...
Suggested
...regulated scope of practice.
Experience/Education:
• BA/BS in nursing degree and current RN license in New York State
• Prefer... ...1-3 years relevant experience in case management, utilization review and/or quality assurance
• Experience in acute episodic care,...
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Monday to Friday
JOB TITLE (#25009): Maternal Nurse Reviewer / Contract - Metropolitan Area
Minimum of 4 years clinical practice experience in a facility or community-based setting
Greenlife Healthcare Staffing is currently seeking a Maternal Nurse Reviewer to fill an opening with...
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Permanent employment
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Private practice
...services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
Responsibilities
Nurse Reviewer - Quality Assurance in Albany, NY
Position Description:
Under the direction of the Bureau of Quality and Surveillance...
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Local area
Immediate start
...Job Description
Job Description RN- Utilization Review Nurse
LTSS/DME
*Full Time 100% Remote Opportunity*
COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGECARE!
VillageCare is looking for a self-motivated and passionate RN as Utilization Review...
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Holiday work
Full time
Local area
Remote job
...effectiveness of medical care.
Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness... .../Experience: Requires Graduate from an Accredited School of Nursing or Bachelor’s degree in Nursing and 2 - 4 years of related...
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Hourly pay
Holiday work
Remote job
Flexible hours
...Living Program, Care at Home Program and Homebound Medicaid. The Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications, change actions, and renewals for all Medicaid funded long term care programs. This unit is...
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Full time
Contract work
...Job Description
Wage/Salary: $20 to $24 per hour
Position Summary:
The Quality Reviewer provides free, quality tax return review for eligible taxpayers. Using IRS approved software (Tax slayer), along with the information provided by the client, and by asking...
Suggested
Hourly pay
Local area
Flexible hours
...disability case management.
Experience/Education:
• MS/NP in nursing degree and current NP license in New York State
• Master’s... ...Minimum experience of 1-3 years in case management, utilization review and/or quality assurance
• Experience in episodic care, wellness...
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Permanent employment
Full time
Temporary work
For contractors
Local area
Remote job
Monday to Friday
...Enter Job Description...
Maintain knowledge of medical record review and EMR systems.
Maintain up-to-date knowledge of HEDIS, QARR and Star specifications
Distribute requests for records and schedules appointments with provider offices to ensure timely completion...
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Vivo HealthStaff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month on-site.
The Utilization Review Physician is the lead clinician for the health plan. Responsible for the administration...
Suggested
...from all defendants is needed to discuss lien re-payment.
OLR/OLT is recruiting for (1) one Supervisor of Nurses to function as a Complex Medical Case Reviewer, who will:
-Conduct medical reviews and analyses claims to calculate injury related Medicaid liens pursuant...
Suggested
Full time
Monday to Friday
JOB TITLE (#24992): Dental Hygienist Reviewer / Contract - Upstate, NY
Minimum of 2 years experience in the provision of clinical services... ...new grads and advanced practitioners to hospitals, clinics, nursing homes, multi-specialty groups, and private practices.
If you...
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Part time
Private practice
...Health plans and auditors trust the Alaffia platform to rapidly execute post-payment claims audits.
We are looking for a Medical Bill reviewer to join our team! Do you have experience reviewing claim forms and auditing provider documentation? Then this position is for you!...
Work from home
Flexible hours
...documentation, recommends and assigns appropriate level of care. The Reviewer is responsible for obtaining the order for appropriate level of... ...from records and through discussion with medical and nursing staff; and,
4. Knowledge of third-party reimbursement systems...
Holiday work
Immediate start
Shift work
Responsibilities:
Review and analyze complex credit actions, considering various factors in assessment areas outlined below.
Conduct ongoing and risk-based monitoring of credit actions, evaluating data and identifying trends.
Assist in individual credit assessments, collaborating...
Job Description
Summarized Purpose:
Effectively reviews documents created within or outside of the company to ensure quality of a standard that meets or exceeds client's expectations. Documents include: regulatory submissions, integrated clinical study reports, serious...
Responsibilities
Peraton seeks a Red Team Cybersecurity Reviewer to provide information assurance expertise in the conduct of DODIN cybersecurity reviews on site at CONUS, OCONUS, and DOD mission partner locations.
Location: Fort Meade, MD and/or Chamberburg, PA.
Travel...
Local area
Remote job
Worldwide
