...Rockford Center is searching for a talented and patient centric Utilization Review Specialist!
Key Responsibilities include:
+ Completes pre... ...Education: Master’s prepared Social Worker or Licensed Registered Nurse.
+ Experience: Previous experience in Behavioral Health...
Suggested
Relief
Immediate start
...consideration for employment.
Medical Oncology Medical Director – Utilization Review
+ Job Family: MED Licensed Physician/Doctor/Dentist
+... ...:
+ Perform physician-level case review, following initial nurse review, of Medical Oncology regimens and supportive care.
+...
Suggested
Holiday work
Full time
Work experience placement
Local area
Remote job
Work from home
Relocation bonus
...you for payment as part of consideration for employment.
Nurse Reviewer I
+ Job Family: MED Licensed Nurse
+ Type: Full time... ...appropriateness of treatment reviews for diagnostic imaging services by utilizing appropriate policies, clinical and department guidelines....
Suggested
Holiday work
Full time
Temporary work
Work experience placement
Local area
Remote job
Shift work
Monday to Friday
ABOUT By the very nature of their duties, Navy Nurses quickly rise to the top of their profession. They provide care, not only for military... ...: Apply leading-edge medical advances at world-class hospitals Utilize some of the most advanced technology on the planet, such as...
Suggested
Full time
Relief
Overseas
...of related experience
Graduate from an Accredited School of Nursing or Bachelors degree in Nursing
LPN License – DE or Compact... ...Understanding State Policies
Skills:
Prior Authorization, Clinical review, Licensed Practical Nurse, LPN , Interqual
About Actalent...
Suggested
...and help us put health first
The Utilization Management Nurse 2 utilizes clinical nursing skills to... ...The Utilization Management Nurse 2 reviews the medical documentation, completes... ...Qualifications
+ Associate’s Degree
+ Registered Nurse license
+ Compact State...
Suggested
Weekly pay
Holiday work
Full time
Temporary work
Apprenticeship
Home office
Monday to Friday
...Evolent for the mission. Stay for the culture.
What You’ll Be Doing:
As a Cardiology, Physician Clinical Reviewer 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...
Suggested
...at Citigroup in Wilmington, Delaware, United States
The Process Review Manager will report into the Business Control Head team for Branded Cards. The role will lead efforts to create standard methodology and processes for control execution across Branded Cards. Excellent...
Suggested
Holiday work
Full time
...at Computer Aid, Inc in Newark, Delaware, United States
Case Review Analyst
Req number:
R1927
Employment type:
Full time... ...meetings, etc.
Ability to conduct repetitive tasks on a computer, utilizing a mouse, keyboard, and monitor.
Reasonable Accommodation...
Suggested
Full time
Apprenticeship
Local area
Saturday
...seeking qualified candidates for our Utilization Management Coordinator - Full-Time position... ...will include:
Conduct admission reviews in collaboration with Assessment and... ...recognized mental health field or a Registered Nursing License
One (1) year experience in...
Suggested
Full time
Local area
...Telephonic RN opportunity.
The Utilization Management Behavioral Health Nurse utilizes behavioral health knowledge... ...Nurse completes medical record reviews from medical records sent from Behavioral... ...Associate’s Degree in Nursing
+ Registered nurse with active Compact...
Suggested
Weekly pay
Holiday work
Full time
Temporary work
Apprenticeship
Remote job
Home office
Shift work
Monday to Friday
...Humana Healthy Horizons in Ohio is seeking a Utilization Management Administration Coordinator 2... ...desired
+ Experience with Utilization Review and/or Prior Authorization, preferably... ...you
+ This is a place where our nurses influence the C-suite.
+ Where software...
Suggested
Holiday work
Full time
Temporary work
Apprenticeship
Work from home
Home office
...part of consideration for employment.
Utilization Management Representative I
+ Job... ...precertification and prior authorization review.
How you will make an impact:
+ Managing... ...cases requiring clinical review to a Nurse reviewer.
+ Responsible for the identification...
Suggested
Holiday work
Full time
Contract work
Temporary work
Work experience placement
Local area
Remote job
Work from home
Shift work
Monday to Friday
...information, such as your job duties and employee benefits offered at the unit, during the interview process.
What You’ll Do: As a Utility Worker at Sodexo, you are a team unifier and solutions driver. Your dedication to team needs and client solutions will make an...
Suggested
Hourly pay
Holiday work
Full time
Flexible hours
...What You’ll Be Doing:
As an Initial Clinical Reviewer, you will be a key member of the utilization management team. We can offer you a meaningful way... ...:
+ Current, unrestricted state licensure as a Registered Nurse- Required
+ Associate or Bachelors in Nursing...
Suggested
Currently hiring
Monday to Friday
...to residents in their apartments, when necessary.
Performs assigned cleaning assignments according to established policies and utilizes the proper cleaning chemicals.
Keeps work areas clean and uncluttered.
Ensures that dishes are readily available for the next...
Local area
Flexible hours
Shift work
...and effective behavioral health clinical review practices to help client’s members with mental... ...Opportunities: As a Behavioral Health Utilization Manager, you will be working with a diverse team of social works, counselors, nurses and psychiatrist to manage daily requests...
...through in our work, as we are united by our mission of creating opportunities for people where they live, learn, and work.
The Loan Review Analyst ( LRA ) performs various functions which are primarily related to the oversight of underwriting and collection decisions,...
Temporary work
Work experience placement
Local area
...will generate tangible value for all stakeholders.
Within the Utilization Management (UM) Strategy team, our goal is to enable members... ...requirement definition, prior authorization and claims review, UM vendor management, analytics / reporting)
+ Knowledge of...
Weekly pay
Full time
Work from home
Home office
Flexible hours
...at Century Engineering, Inc. in Dover, Delaware, United States
Utility Locator
ID
2024-6634
Job Locations
US-DE-Dover
Category
CoMET/CM/Field/Lab
Position Type
Regular Full-Time
Step into Your New Role
Century Engineering, a Kleinfelder...
Full time
Remote job
...help us put health first
Humana Healthy Horizons is seeking a Utilization Management Behavioral Health Professional 2 who utilizes... ...Guidelines
+ Possess subject matter expertise in Utilization Review of inpatient and outpatient behavioral health services
+ Experience...
Weekly pay
Holiday work
Full time
Temporary work
Apprenticeship
Private practice
Work from home
Home office
...file universe preparation and UM file reviews.
+ Works closely with operational areas... ...Health Plan Accreditation and/or Utilization Management
+ Experience compiling NCQA... ...Working knowledge using Power BI
+ Registered Nurse or Behavioral Health Licensed Professional...
Weekly pay
Holiday work
Full time
Temporary work
Remote job
Work from home
Home office
Flexible hours
Monday to Friday
...What Is the Opportunity?
This position is responsible for reviewing outside counsel’s invoices for compliance with Travelers’ Retention... ...and negotiate resolution of billing issues or disputes.
+ Utilizes claim file and document review to obtain claim strategy...
Holiday work
...bonus
Primary Function
The Lead Registered Nurse (RN) - Ambulatory is a clinically... ...completion of patient care.
~ Utilizes resources including but not limited to... ...immunization accuracy audits, and EMR chart reviews to provide quantitative and qualitative...
Relocation bonus
...what we can achieve. Together.
Summary
DLA Piper seeks review attorneys for its internal Document Review Center. We are looking... ..., including analysis and selection of documents to be utilized in deposition preparation sessions, and preparation for witness...
Remote job
...Inc. in MilfordMilford, Delaware, United States
Job Title: Registered Nurse
Duration: 3 months with possible extension.
Shift... ...evaluates direct nursing care.
Develops, implements and/or reviews nursing care plans.
Provides health care instruction and guidance...
Local area
Shift work
3 days per week
Monday to Friday
...or property owner at the work site.
Your Responsibilities as a Locator:
+ Correctly, safely, and efficiently locate underground utilities, including telecommunications, electric power, cable TV, gas, water, and sewer systems.
+ Thoroughly search for underground utilities...
Hourly pay
Holiday work
Full time
For contractors
Second job
Outdoor
Weekend work
...City National Bank in Newark, Delaware, United States
KYC REVIEW ANALYST - OPS
WHAT IS THE OPPORTUNITY ?
Conduct Enhanced... ...) reviews for commercial loan borrowers and prospect reviews utilizing a variety of internal bank systems and external research tools...
Hourly pay
...States
We are looking for a fast-learner who can work independently and collaborate well with team members!
As the Consumer Credit Review Executive Director, you will be responsible leading a team that provides coverage of assigned portfolios within the Consumer &...
Flexible hours
...River Laboratories in Newark, Delaware, United States
Data Review Scientist- Sequencing
Req ID #: 221292
Location:
Newark... ...clinical laboratory testing needs and manufacturing activities. Utilizing this broad portfolio of products and services enables our clients...
Contract work
Worldwide
Flexible hours