Search Results: 4,543 vacancies
Title: RN Utilization Review II
Description: The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety...
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Permanent employment
Immediate start
...unrestricted and active TX license to practice medicine. Must have understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases. (Note: Position does not provide direct patient care or medical diagnosis.)
Candidate...
Suggested
Permanent employment
For contractors
Remote job
Shift work
Weekday work
...work onsite for quarterly meetings.
~3, 12 hour shifts. Saturday, Sunday, Monday.
JOB SUMMARY
The Utilization Review Registered Nurse (RN) provides a clinical review of cases using medical necessity criteria to resolve the medical appropriateness of inpatient...
Suggested
Immediate start
Remote job
Shift work
Weekend work
Sunday
Saturday
...making this a great experience to add to your resume. Come join their winning team!
This Contract role as a Remote Physician Reviewer will be responsible for evaluating clinical service requests made by an organization's members and providers, uses clinical judgment...
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Remote job
Contract work
...Global Risk Review (GRR) provides independent, objective, reliable, valued and timely assurance to the Boards, the Committees, the Citigroup Chief Risk Officer, the Citigroup Chief Credit Officer, senior management and regulators over the effectiveness of credit, capital...
Suggested
Holiday work
Full time
Work experience placement
Support and provide coding and compliance training to clinical personnel, billing, and/or other client staff. Establish effective communication with clinical staff, and/or hospital staff to address documentation, coding, and reimbursement issues. Use Coder, Analyst, Healthcare...
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Remote job
...Job Description
Job Description Summary:
The Sr Vice President, Credit Review is charged with steering the strategic management, oversight and governance necessary to identify, evaluate and monitor the company’s loan review and credit and compliance risk related...
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Holiday work
Part time
Work experience placement
Relocation
...documentation
Communicate with healthcare facility Clients to ensure accuracy of timesheet documentation
Facilitate detailed review of Provider pay documentation
Facilitate detailed review of Provider expense reconciliation data
Responsible for accurate entry...
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Full time
Locum
...indicators for tracking covenant compliant obligors, industry and subsegment research and consolidation of KPI/KRI for the Risk Directed Reviews and implement Tableau visualization. While working on these priorities the analysts is expected to use SAS, Python, Advanced Excel,...
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Holiday work
Full time
...Working from instructions and pre-established guidelines, under general supervision, assigns medical necessity requests to a qualified reviewer and follows-up to ensure timely determination is delivered based on state/URAC guidelines in accordance with Concentra policies,...
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Full time
**Global Risk Review (GRR)** provides independent, objective, reliable, valued and timely assurance to the Boards, the Committees, the Citigroup Chief Risk Officer, the Citigroup Chief Credit Officer, senior management and regulators over the effectiveness of credit, capital...
Suggested
Holiday work
Full time
Work experience placement
ezURs is a URAC accredited Independent Review Organization. ezURs affords our clients true nationwide physician reviewer coverage. Our credentialed, board certified physicians are versed in evidenced-based practices and are actively practicing medicine, keeping up on all...
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Full time
Immediate start
Remote job
Flexible hours
...as a liaison between managed care organizations and the facility’s behavioral health clinical treatment team.
Conducts clinical reviews in accordance with certification requirements of insurance plans or other managed care organizations.
Monitors patient length of...
Suggested
Full time
Flexible hours
...you are a person with a disability and need a reasonable accommodation to use our search tools and/or apply for a career opportunity review Accessibility at Citi .
View the " EEO is the Law " poster. View the EEO is the Law Supplement .
View the EEO Policy...
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Holiday work
Permanent employment
Full time
Local area
JOB SUMMARY
This job is responsible for ensuring that all appropriate billing charges for complex service lines are being captured, documented, charged and reimbursed for the assigned department in accordance with policies and procedures, and applicable regulatory...
Suggested
Hourly pay
Holiday work
Work experience placement
Local area
Remote job
Relocation bonus
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...
Holiday work
Temporary work
Position : -Network security with a good understanding of Firewall and the rule review process (L3 level)
Location: - Plano TX, - Hybrid role:-3 days Onsite(Tue/Wed & Thur) and 2 days remote
Duration: Contract
Job Description:
Note:-Should have good understanding...
Permanent employment
Contract work
Remote job
...every step of the way. Join us to invest in yourself, your career, and the financial world.
Job Summary:
The Credit Risk Review Leader for the Second Line of Defense in our OCC-regulated bank leads the Consumer Loan Review team. This team independently...
Remote job
...integrated career centers, sector-focused centers and community, and partner sites.
Job Description
- Conduct case file and record reviews for compliance and identifying opportunities for improvement or corrective actions
- Ensuring contractual performance...
Hourly pay
Local area
Flexible hours
ezURS.com Inc., has an ongoing need for Pain Management Physician Consultants to perform a wide variety of world-class utilization review, disability, peer reviews products in multiple lines of business including health, workers compensation, and auto liability cases....
Part time
Remote job
Flexible hours
