Average salary: $88,000 /yearly
More stats ...Elevance Health Medical Oncology Medical Director - Utilization Review Atlanta , Georgia Apply Now
Utilization Management of Medical Oncology Benefits
Carelon Benefits Management
$20,000 Sign On Bonus
Location : The ideal candidate will live within 50 miles...
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...benefit of all: our employees, customers and communities.
Responsibilities
Responsible for performing mid-complex commercial credit reviews to assist in the ongoing management of credit risk; achieving goals as established in the Department's annual review schedule;...
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...Quality Control / Credit Review Professional - Vice President page is loaded Quality Control / Credit Review Professional - Vice President
Apply locations New York, NY time type Full time posted on Posted 2 Days Ago job requisition id 10064581-WD Do you want your...
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...Capital Planning Review Team – Recovery and Resolution Planning
The Capital Planning Review Team (“CPRT”) is mandated by the Capital Committee and Board of Directors to lead the holistic independent review and challenge of the capital planning process across the capital...
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Full time
...Job Description
Job Description Responsible for review, auditing and data-entry of medical bills for multiple states and lines of business.
ESSENTIAL FUNCTIONS & RESPONSIBILITIES:
Responsible for auditing medical bills to ensure that they are appropriate and...
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Minimum wage
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Local area
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...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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...independent initiative and judgment, the Medicaid Eligibility Specialist is responsible for interviewing Medicaid applicants and reviewing their documentation to determine eligibility for Medicaid.
The Office of Constituent Services (OCS) is seeking (1) Eligibility...
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...An employee in this class is responsible for the review and evaluation of real property appraisals made by appraisers contracted by the County. The incumbent assists in the collection of data to establish fair market values of parcels of property, and exercises considerable...
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...HEDIS Reviewer
990 Stewart Ave, Garden City, NY 11530, USA
Req #879
Monday, April 29, 2024
Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general...
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...NYC Department of Design and Construction, Public Buildings Division, Architecture & Engineering Unit seeks an Electrical Design Reviewer.
The duties for this position will include, but are not limited to, project scoping, design and/or review of consultant drawings...
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For contractors
Description
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Care Review Clinician
Remote: New York, New York, US
Salary: $45.00 Per Hour
Job Code: 348679
End Date: 2024-05-24
Days Left: 3 days, 3 hours left
Apply
State Registered...
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As a Clinical Reviewer you will complete the full spectrum of activities related to State Independent Review Organization (IRO) case determinations. Conducting clinical level review, determining physician level assignment, managing case staging between external physician...
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...collections and centralized data reporting. The areas are Centralized Data Entry (CDE), Claims & Collections (C&C), Division of Financial Review and Processing (DFRP), Office of Liens & Trust (OLT) and Supplemental Nutrition Assistance Program - Claims & Recovery (SNAP-CR)....
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...Utilization Review Analyst
Job Details
Job Location
Bronx, NY
Position Type
Full Time
Education Level
4 Year Degree
Salary Range
$45,000.00 - $50,000.00 Salary/year
Travel Percentage
Up to 25%
Job Shift
Day
Job Category
Nonprofit...
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...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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...employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)
Responsibilities:
Quality Review Auditor (QRA) is responsible for ongoing audits of the care management staff, quality assurance, accuracy and overall integrity of...
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Full time
Part time
Relocation bonus
Flexible hours
The Utilization Review Coordinator provides a broad range of clerical and technical support for Utilization Management and Home Safety Modifications.
Performance Responsibilities and Standards
Provides a wide range of administrative support-related tasks....
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Immediate start
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...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...
Hourly pay
Local area
Flexible hours
...regulatory requirements.
OQA&FI is recruiting for (2) two Principal Administrative Associate II to function as a Quality Control Case Reviewers, who will:
- Review POS, HRA One Viewer of imaged/scanned documents, Welfare Management System (WMS) data and other pertinent...
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Full time
Local area
...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...
Full time
Monday to Friday
...Homeless Services is recruiting for one (1) Administrative Community Relations Specialist NM-II to function as the Director of Packet Review and Processing who will:
- Be responsible for overseeing the day-to-day work operations of the HPD referral team.
- Stand...
Permanent employment
Full time
Night shift
Monday to Friday
...POSITION SUMMARY
The Utilization Review Care Manager performs initial, concurrent, and retrospective reviews with various payers. Care managers request appropriate level of care based on NYS LOCADTR and medical necessity.
The Utilization Care Manager partners with...
Hourly pay
Shift work
...on the Civil Engineer level. The work and training will be in one or more of the following engineering areas: development, design review, and construction inspection. Performs mathematical calculations. The selected candidate will work mainly as the MS4 programs I/C facilities...
Full time
...perspective on workplace flexibility.
**Must have a New York State clinical license.**
**Position Purpose:** Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in...
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Holiday work
Remote job
Flexible hours
...and Opportunities, Administrative Services, Purchasing Management, Payments and Accounting, Large Payments and Accounting, Contract Review & Negotiations Unit, and Scope/Specifications Review Unit.
The Contract Review and Negotiations Unit is responsible for...
Contract work
Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if required) certified by the American Heart Association.What makes Mindlance Health different?Mindlance Health has thousands of rewarding travel assignments...
Weekly pay
Flexible hours
...Description
APPLICANTS MUST BE PERMANENT IN THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE.
The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with Agency policy and changes under welfare reform. This is...
Permanent employment
Full time
Monday to Friday
...Administration (HRA), Department of Social Services (DSS) and Department of Homeless Services (DHS). Within DSS-AO, the Process Evaluation Review Team (PERT) was created as an independent unit within the Office of Quality Assurance and Fiscal Integrity to aggressively monitor...
Permanent employment
Full time
...the role of (1) one Administrative Director of Social Services M-3, serving as the Executive Director for the Clearance & Apartment Review.
Under the direction of the Associate Commissioner for Rehousing Support Division, with wide latitude for exercise of...
Permanent employment
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...