Search Results: 8,206 vacancies
ESSENTIAL FUNCTIONS:
•Act as liaison between managed care organizations and the facility professional clinical staff.
•Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow...
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For contractors
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspec Clinical, Clinician...
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Overview:
Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond....
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...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...
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Remote job
Work experience placement
Internship
Local area
Overview:
Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond....
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...multidisciplinary team in completing pre-screening assessments of prospective patients. Ensures completion of appropriate clinical review of all applicable patients as stated in system utilization management plan. Oversees Clinical Review Specialist as indicated. Maintains...
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Relief
Remote job
Shift work
2 days per week
3 days per week
Monday to Friday
...Role - P hysician Medical Reviewer
Duration – Weekend job
Remote
Pre-service reviews only - at least 4 cases per hour is the goal. Training will be for 3-4 days, Mon- Thurs 8a m -5p m
Seeking P hysician medical reviewer for REMOTE...
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Hourly pay
Holiday work
Full time
Remote job
Shift work
Weekend work
Sunday
Saturday
...Land Plan Reviewer I
Hours: Full-Time
Service Area: Urban Planning
Reports to: Deputy Southeast Officer Director and Principals in Support of City of Atlanta staff
Supervises: Not Applicable
Location: Atlanta
The...
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Full time
Contract work
Local area
Afternoon shift
...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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Remote job
Hourly pay
Full time
Flexible hours
...level management position that is responsible for providing strategic direction, leadership, and coordination of CAS's Credit Risk Review cyclical risk-based audit plans. As an Independent Risk Review function, Credit Risk Review provides independent assessment and effective...
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Holiday work
Temporary work
...accessibility and value of health care.
Currently, Alliant Health Solutions, a "2023 Best Place to Work and Healthiest Employer", seeks a Review Nurse, PA/UM. The Review Nurse to conducts prior approval and precertification reviews for Georgia Fee-for-Service Medicaid...
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Contract work
...Position Purpose: The Services Sourcing Manager will manage the execution of the line review process and award of business to install Service Providers. This role will work closely with National Install Merchants to understand the program strategy and develop a line...
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Hourly pay
Work experience placement
Local area
Immediate start
Night shift
...explore the job opportunities we have to offer.
General Description and Classification Standards
The purpose of this job is to review construction plans to ensure compliance with regulatory codes, ordinances, and laws. Duties include but are not limited to...
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Temporary work
For contractors
...explore the job opportunities we have to offer.
General Description and Classification Standards
The purpose of this job is to review construction plans to ensure compliance with regulatory codes, ordinances, and laws. Duties include but are not limited to...
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Temporary work
For contractors
...Responsible for carrying out precertification and medical necessity reviews on all designated referrals as well as targeted outpatient procedures, services and inpatient admissions. The activities will include telephonic review for medical necessity of the RN designated...
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Permanent employment
Full time
Contract work
Local area
Shift work
Internal Revenue Agent (SR Employee Plans/Exempt Org. Reviewer)(12 mos Rost) NTE 1-yr, MBE (Amended)
...opportunity to learn to perform these duties and receive training to help you grow in this position.
Independently analyzes and reviews the most difficult completed Employee Plans determination and examination reports involving large and complex pension, profit-sharing...
Permanent employment
Full time
Temporary work
Part time
Work experience placement
Remote job
Relocation
Day shift
Monday to Friday
...Key responsibilities include evaluating and monitoring mental health and substance abuse treatments, conducting prior authorization reviews, and performing concurrent reviews for inpatient behavioral health services. Your expertise will guide decision-making processes to...
Hourly pay
Full time
Remote job
...Responsible for carrying out medical necessity reviews on all designated referrals for Home Care, DME Specialty Care services. The activities will include telephonic review for medical necessity of the designated services using established criteria and guidelines for...
Full time
Contract work
Local area
Immediate start
Shift work
Weekend work
...schedule and be compensated on a per case basis as a 1099 independent contractor.
JOB SUMMARY:
Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare...
Contract work
Temporary work
For contractors
Remote job
Flexible hours
Monday to Friday
...and value of health care.
Currently, Alliant Health Solutions, a "2023 Best Place to Work and Healthiest Employer", seeks an UCR Review Nurse. The Medicaid Utilization and Compliance Review (UCR) Nurse, as a member of a professional multi-disciplinary work team, is...
Remote job
Night shift
