Search Results: 66,242 vacancies
Department/Unit:
Care Management/Social Work
Work Shift:
Day (United States of America)
Responsible for Utilization Management, Quality Screening and Delay Management for assigned... ....
• While performing utilization review identifies areas for clinical documentation...
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Permanent employment
Shift work
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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...assigns appropriate level of care. The Reviewer is responsible for obtaining the order for... ...and Appeal team.
11. Notifies the managed care companies of patients requiring transfer... ..., one year of which has been served in Utilization Review/Quality Assurance; or,
2....
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Holiday work
Immediate start
Shift work
...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
...innovative and experienced leader to join our team as the RN Utilization Management Nurse. Compensation will be commensurate with experience.... ...UM) determinations in accordance with Article 49-Utilization Review. •Ensure UM is completed by following all regulatory guidelines...
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..., 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 DRG accuracy. The DRG Reviewer will ensure that accurate...
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Full time
Work experience placement
...FTI Consulting's Acuity team which includes supporting, coordinating, managing and participating in document reviews at the direction of FTI clients. As part of their role, this position will utilize various platforms including Relativity, Nuix Discovery and Reveal/Brainspace...
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Full time
Remote job
Flexible hours
...direction of the Senior Director of Clinical Review, the Clinical Review Nurse is... ...coordinates with the Provider/IDT for appropriate utilization of services
* Documents case reviews,... ...quality of care concerns to Quality Management.
* Maintains confidentiality of all information...
Suggested
Flexible hours
...living through the Community Alternative Systems Agency (CASA), Managed Long Term Care (MLTC) Program, the Assisted Living Program,... ...Medicaid Eligibility Unit is responsible for the Medicaid eligibility review and processing of initial applications, change actions, and...
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Full time
Contract work
...are actively scaling our company.About the Role & What You'll Be DoingJoining our team as a Client Relationship Account Manager for our Bill Review Clients means being at the forefront of Alaffia's commitment to excellence in client service and satisfaction. You will play...
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Contract work
Remote job
Flexible hours
...estate finance etc. You'll be responsible for providing front end risk analysis including examinations, transaction reviews, risk assessments and issue management. You'll be a subject matter expert interfacing with business heads and executive management, including...
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Bank staff
Flexible hours
3 days per week
...Peraton seeks a Red Team Cybersecurity Reviewer to provide information assurance expertise... ...while ensure scanning of all site-managed network spaces.
Perform technical Security... ...above using SRGs, STIGs, or best practices utilizing the most appropriate certified...
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Local area
Remote job
Worldwide
...Enter Job Description...
Maintain knowledge of medical record review and EMR systems.
Maintain up-to-date knowledge of HEDIS,... ...implementation of quality improvement activities as directed by Quality Management programming needs. Support interdepartmental and internal teams...
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...gallons of high quality drinking water, managing wastewater and stormwater, and reducing... ...combined municipal water and wastewater utility in the country, with nearly 6,000 employees... ...management practices (BMP) projects, reviewing, and managing designs, modeling, and designing...
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Internship
Summer internship
Rotational program
...welfare and juvenile justice services and community supports. ACS manages community-based supports and foster care services, and provides... ...that support best case practice agency wide.
The Medical Review Authorization and Monitoring Unit (MRAM) reviews foster care medical...
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...Job Description
Job Description POSITION OVERVIEW:
The Utilization Manager is responsible for the day to day functions of collaborative... ...pre-admission through discharge, ongoing medical necessity reviews and interdisciplinary team support with respect to MCO...
JOB TITLE (#24992): Dental Hygienist Reviewer / Contract - Upstate, NY
Minimum of 2 years... ...services or in quality improvement/utilization reviews
Greenlife Healthcare Staffing... ...personnel where appropriate.
Utilizes data management tools appropriately to record...
Permanent employment
Contract work
Part time
Private practice
...Highly Regarded NYC Non-Profit Managed Care Plan Looking for a Director of Utilization Management
This Jobot Job is hosted by: Joshua Tacke
Are you a fit? Easy Apply now by clicking the "Apply Now" button
and sending us your resume.
Salary: $130,000 - $150,000...
Remote job
...a clinical professional on our Medical Management/Health Services team. Centene is a diversified... ...medical necessity and clinical reviews of authorization requests to determine... ...providers and/or interdepartmental teams on utilization processes to promote high quality and...
Hourly pay
Holiday work
Remote job
Flexible hours
Job Description: Position Purpose:
Provide case management and clinical services to employees within their regulated scope of practice... ...of 1-3 years relevant experience in case management, utilization review and/or quality assurance
• Experience in acute episodic care...
Permanent employment
Full time
Temporary work
For contractors
Local area
Remote job
Monday to Friday
