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- ...deliver clinical coverage and medical claims reviews. Our role is to empower providers and... .... The **Medical Director** provides physician support to Enterprise Clinical Services... ...application of clinical knowledge in various utilization management activities with a focus on...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote work
Optum
Glendale, AZ19 minutes agonew - ...growing Value Innovations efforts. This key Physician will provide expertise and leadership on... ..., specifically Clinical Documentation Review with expertise in application of DRG... ...collaboration with other programs, such as hospital utilization management and claims adjudication teams...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote work
Optum
Paradise Valley, AZ19 minutes agonew - ...advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.** The role of the Psychologist Peer Review involves applying clinical criteria and benefit plan requirements to Commercial, Medicaid, and Medicare cases, and making clinical...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote workWork from homeMonday to Friday
- ...with a Fortune 4 industry leader. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team... ...for conducting hospital and post-acute utilization reviews for the state of California. The Medical Directors work with groups...SuggestedMinimum wageWork experience placementLocal areaRemote work
Optum
Phoenix, AZ10 minutes agonew - ...our business. Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-...SuggestedPart timeWork at office
- ...and help us put health first** The Senior Utilization Management Behavioral Health... ...participates in discussions with treating physicians to explain the rationale behind utilization... ...decisions, + Work includes computer-based review of moderately complex to complex clinical...SuggestedBi-weekly payFull timeTemporary workApprenticeshipWork at officeRemote workWork from homeHome office
- ...advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. \n \n Psychologist Peer Reviewer is for an Outpatient Public Sector or Applied Behavior Analysis which involves applying clinical and benefit plan criteria to...SuggestedMinimum wageFull timeWork experience placementInternshipWork at officeLocal areaRemote workWork from homeMonday to Friday
Optum
Phoenix, AZ14 days ago - ...correspondence letters based and supports overall team needs. Reviews outcomes in accordance with National Committee for Quality Assurance... ...to interdepartmental teams on training needed within the utilization management team based on trends + Provides feedback to...SuggestedHourly payFull timePart timeWork at officeLocal areaRemote workFlexible hours
- ...or LPN Licensure** **Position Purpose:** Performs concurrent reviews, including determining member's overall health, reviewing the... ...member medical records in health management systems according to utilization management policies and guidelines + Works with healthcare...SuggestedHourly payFull timePart timeWork at officeRemote workFlexible hours
- ...Description Job Description Job Description: Penalty Review Specialist: Examine and analyze data as presented by the customer... ...conformance with procedural standards, statutes, and tax laws. Utilize problem solving, critical thinking and decision-making skills...SuggestedWork at officeLocal area
S R INTERNATIONAL INC
Phoenix, AZ3 days ago - ...growing Value Innovations efforts. This key Physician will provide expertise and leadership on... ..., specifically Clinical Documentation Review with expertise in application of DRG... ...collaboration with other programs, such as hospital utilization management and claims adjudication teams...SuggestedMinimum wageFull timeWork experience placementLocal areaRemote work
- ...**Candidates must reside in Arizona for this remote position.** **Position Purpose:** Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team. + Monitors...SuggestedWork at officeRemote workFlexible hours
- Loan Support Specialist -Utility Support Loan Operations Tacoma, Washington Roseburg, Oregon Liberty Lake, Washington Phoenix, Arizona... ...document creation, lien perfection, escrow/tax support, flood review or general ledger. + Responsible for understanding complex retail...SuggestedWork at officeImmediate startFlexible hours
- ...Repayment Services program office after review of the EDRP application. Former EDRP participants... ...total rewards package. VHA Physician Total Rewards. Recruitment Incentive (Sign... ...that are not REAL ID compliant cannot be utilized as an acceptable form of identification...SuggestedFull timeContract workFreelanceSeasonal workWork at officeLocal areaRelocation package
- ...Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Pain Management Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical...SuggestedWork at officeNight shiftAfternoon shift
- **Become a part of our caring community and help us put health first** The Compliance Nurse 2 reviews utilization management activities and documentation to ensure adherence to policies, procedures, and regulations and to prevent and detect fraud, waste, and abuse. The...Bi-weekly payFull timeTemporary workApprenticeshipWork at officeLocal areaRemote workWork from homeHome officeFlexible hoursMonday to Friday
- ...Evolent for the mission. Stay for the culture. **What You'll Be Doing:** Job Description As a Clinical Reviewer, Nurse, you will be a key member of the utilization management team. We can offer you a meaningful way to make a difference in patients' lives, in a non-clinical...Work at office
- ...with a Fortune 4 industry leader. We are currently seeking a Utilization Management Medical Director to join our Clinical Performance team... ...for conducting hospital and post-acute utilization reviews for the state of California. The Medical Directors work with groups...Minimum wageFull timeWork experience placementLocal areaRemote work
- ..., patient, and family, coordinates and promotes patient health utilizing evidence-based practice in the delivery of professional nursing... ...knowledge, skill, and competency. Provides timely feedback and review of care delivery to ensure maintenance of patient safety, infection...Full timeReliefShift work
Phoenix Children's
Phoenix, AZ4 days ago - ...along with some medical students, so teaching is a strong component in this role We have been trained in the OnTrackNY model and utilized a variety of recovery resources to improve the healthcare of our members New building that also has an FQHC, pharmacy, and...Permanent employmentFull time
Britt Medical Search
Phoenix, AZ5 hours ago - ...medical necessity and appropriateness of care. + Conduct peer reviews with psychologist and licensed therapist/certified Behavior Analyst... ...to provide education on best practice models and utilization management processes + Interact with the Medical Director, or...Full timePart timeWork at officeRemote workFlexible hours
- ...process from operational areas, including physicians + Answers billing correspondence answer... ...specialties specifically assigned + Review claim payments for accuracy and compliance... ...claims problems with insurance carriers + Utilize available tools to keep accounts...Hourly payMinimum wageFull timeWork experience placementLocal areaRemote workLive inShift workMonday to Friday
$76k - $101k
...towards our shared purpose. If you elect to interact with us via our website, please only use or . Additionally, our recruiters utilize email addresses with the @lifestance.com domain. Other websites and domains are not affiliated with LifeStance Health and may...Full timePart timeRelocation packageFlexible hoursLifeStance Health
Peoria, AZ5 hours ago- ...responsibilities such as staff performance reviews. This role is eligible for TN... ...of radiologic technologists, nurses, and physicians working in tandem to deliver unparalleled... ...Accountability and Autonomy . This team values utilizing their education to it’s full potential....Immediate start
- ...and practice efficiencies which allow its physicians to optimize care for each patient, every... ...academic pursuits. The practice utilizes unique and powerful clinical quality and... ...assessments, including medical history reviews and physical examinations. Utilize diagnostic...
Center for Orthopedic Research and Educa
Phoenix, AZ22 days ago - ...and practice efficiencies which allow its physicians to optimize care for each patient, every... ...academic pursuits. The practice utilizes unique and powerful clinical quality and... ...employment laws. For further information, please review the Know Your Rights notice from the...
- ...ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other internal guidelines. - Review, research, analyze and evaluate information to assess compliancy between a process or function and the corresponding written...Contract workWork experience placementRemote work
- ...contribute to Sedgwick being a great place to work. Great Place to Work® Most Loved Workplace® Forbes Best-in-State Employer Estimate Review Specialist Sr. (Repair Solutions) **PRIMARY PURPOSE:** To review all estimates and supporting documentation submitted by...For contractorsFlexible hours
- ...Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Estimate Review Specialist Sr. (Repair Solutions) **PRIMARY PURPOSE:** To review all estimates and supporting documentation submitted by...For contractorsFlexible hours
- ...Program: Start a year-long mentorship and training program to expand your clinical repertoire while earning up to 14 CEUs. Case Reviews: Overview, discussion and clinical coaching for current clients and interventions. Team Integration: Introduction and regular check...Work from homeRelocation
Hopebridge
Phoenix, AZ58 minutes agonew
