Search Results: 26,324 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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Permanent employment
Shift work
...what they do and are deeply committed to our Mission, you too can be part of our transformation across the enterprise.
DRG Reviewer
Full-Time
The DRG Reviewer reports to the Director of Coding, HIM (Health Information Management). The DRG Reviewer oversees...
Suggested
Full time
Work experience placement
...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...
Suggested
Full time
Contract work
...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...
Suggested
...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...
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Flexible hours
A company is looking for a Reading Assessment Reviewer.
Key Responsibilities:
Review achievement level descriptors for each grade level
Review assessment items to ensure accurate measurement of student performance
Complete one hour of review per grade level
Required...
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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...
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...developing medical and mental health policies, programs, and
initiatives that support best case practice agency wide.
The Medical Review Authorization and Monitoring Unit (MRAM) reviews foster care medical
records and ensures compliance with the established health standards...
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...Dream Teams.
Who You Are:
The Compliance Analyst will be responsible for implementing the firm's compliance policies related to the review and approval of marketing materials relating to Galaxy Digital. The Compliance Analyst will also be asked to help review marketing...
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Holiday work
Local area
Remote job
Flexible hours
Candidate criteria:
Willing to work weekends (expectation is they work a minimum of at least 4 weekend shifts in a 6 week period. These weekends can be all Saturdays, all Sundays, back to back Saturday/Sunday. We try to have them off together but they also have to understand...
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Holiday work
Remote job
Shift work
Weekend work
Sunday
Day shift
Saturday
...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!...
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Work from home
Flexible hours
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...
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Local area
Remote job
Worldwide
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...
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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...
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About the Role:
Grade Level (for internal use):
09
Title: Rating Analyst, Review & Validation
Grade (relevant for internal applicants only): 09
Location: New York, NY; Chicago, IL
Team:
The Review & Validation team has global responsibility for the review and validation...
Suggested
Full time
Work experience placement
Second job
Worldwide
Flexible hours
...improving water quality. The Bluebelt staff is monitoring in operation and under-construction best management practices (BMP) projects, reviewing, and managing designs, modeling, and designing new Bluebelt systems in New York City.
This position will be part of an internal...
Internship
Summer internship
Rotational program
...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 to SSL-104b on cases...
Full time
Monday to Friday
...Requisition ID: req47210
Job Title: Unpaid Tax Preparer and Quality Reviewer
Sector: Economic Recovery & Livelihood
Employment Category: Intern
Employment Type: Part-Time
Compensation: USD 0.00 - 0.00 Hourly
Location: New York, NY RAI USA
Work...
Hourly pay
Part time
Internship
Remote job
Work from home
Afternoon shift
...document the intensity and the severity of illness. Based on documentation, recommends and assigns appropriate level of care. The Reviewer is responsible for obtaining the order for appropriate level of care from the Physician when there is no justification for the current...
Holiday work
Immediate start
Shift work
Summary of Job
Support contract performance management of a large health system. Review and analyze suspected underpaid and overpaid claims from hospital, ancillary, and provider groups based on contractual and industry guidelines. Identify and analyze single issues...
Remote job
Contract work
Work experience placement
