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The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed. Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator.
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Job Overview: The Utilization Review Specialist is responsible for all aspects of the authorization of treatment via insurance and managed care companies. The Utilization Review Specialist provides appropriate client information to third party payers regarding the medical necessity of treatment in a timely manner.
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Utilization Review Specialist/Behavioral Health Substance Abuse. Prior Utilization Review experience in a Substance abuse environment is mandatory. Performs other duties as assigned by the Director of Utilization Review.
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CT/ X-Ray Tech needed ASAPREQUIRED SKILLS: Really looking for someone that would consider signing on after contract. Review and evaluate x-ray information to determine if images are satisfactory for diagnostic purposes.
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Author and review stress deliverables including qualification plans (QP), interface loads reports (ILR), static test plans (STP), dynamic test plans (DTP), abuse test plans (ATP). A Senior Stress Engineer is needed for one of the world's largest suppliers of aerospace and defense products in the Everett, WA area.
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Evaluate the system’s sources of changes, such as Deficiency Reports (DRs), Problem Reports (PRs), Change Requests/Proposals (CRs/CPs), Request For Change (RFC), and AF Form 1067s; determine the security impacts of proposed or actual changes to the system, environment, threats, and vulnerabilities; and if any, update all needed RMF artifacts to reflect the changes/revisions.
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The Conflicts Attorney will handle additional assignments from the firm’s Professional Responsibility Counsel, the Committee on Professional Responsibility and firm administration, as needed. The Conflicts Attorney will handle additional assignments from the firm’s Professional Responsibility Counsel, the Committee on Professional Responsibility and firm administration, as needed.
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Daily review of charts to determine if pre-certification/pre-authorization or referrals are needed. To ensure procurement of accurate pre-certification authorization/referral for applicable returning and new patients as well as review and completion of accurate, complete patient charts.
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Accompany the Housing Manager, whenever necessary, to assist in information gathering, and to provide presentations needed by the Assistant Public Housing Director. Coordinate/review all maintenance functions daily with Housing Manager.
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Incumbent will supervise execution of the monthly applications portfolio review, and work with the PMO Director on strategic level reporting and planning. Incumbent will work with the PMO Director to plan and manage utilization, including responsibility for hiring and management of consulting resources as needed.
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Regularly conferring with Family Court Services District Manager and meeting all requirements for documentation and timelines is critical; Responsibilities also include conducting family law file review and case screenings as well as assisting parents with other alternative dispute resolution resources.
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Includes servicing functions in FIS and Service Gateway such as daily reporting of loan level transactions, review of draft reports, cash manager, reconciliation, Loan Level Reporting, error corrections, MAS and Loan Level Reconciliation Differences, Repayment Plans, Loan Mods, Short Sales, DIL, Charge-offs, Third-party sales, and repurchases along with activation and inactivation’s.
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Mentor and monitor work delegated to Utilization Review LVN/LPN and/or Authorization Coordinator as needed. Collaborate with Patient Access, Case Management, Managed Care and Business Office to improve concurrent review process to avoid denial or process delays in billing accounts.
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Provide training and technical assistance to staff, as needed, regarding HMIS, data entry, report generation and review etc. Review check requests for errors and consistency issues; interact with case management staff to request missing check request documentation and follow up with staff to ensure all documentation is accurate and clear; drive between program sites to transport paperwork as needed.
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The Quality Review Manager is responsible to work autonomously to complete full audit, review and approval of the following, but not limited to: Life Care Plans, Medical Cost Projections, Medicare Set-Aside Allocations, Legal Nurse Reviews, Complex Nurse Reviews, Bill Reviews, initial and progress reports for medical or vocational case management files and other reports as needed within the scope of nursing practice and certifications.
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needed review jobs
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