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Utilization review tech will follow up on all denials while working closely with the Corporate/Facility Utilization review teams, Business Office and Case Managers. The Utilization review tech will further support the department needs for Release of Information, discharge coordination or other duties as assigned.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Consults the other supervisory personnel to maximize census and to provide guidance to the doctor on call and utilization review case management regarding admission criteria, insurance issues, and bed availability.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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As Physician Reviewer/Advisor for Disability Peer Review, you will utilize clinical expertise to review medical records provided and return an independent, professional opinion on the clamants functionality and restrictions or limitations as it relates to an application for disability benefits or the current status of disability.
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The Compliance Specialist will become an extension of the customer compliance team using Protenus, and execute case triage and review procedures established in partnership with those customer teams.
Full-timeExpandApply NowActive JobUpdated 8 days ago - UpvoteDownvoteShare Job
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Three (3) years experience working in a case management or utilization review role preferred. Communicates information that will impact the discharge plan to the Transitional Care Coordinator and Case Managers to ensure high quality care coordination.
ExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Documents plan of care and utilization issues in appropriate locations, including but not limited to: case management/utilization review software and the multidisciplinary plan of care document on all assigned patients.
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Assists engineers, appraisers, and financial analysts in the appraisal and examination process and provides assistance with the extraction, analysis, input, and review of data. Provides assistance to examiners and management with Issue Management System (IMS) issues assignment as a team member on audits, establishing cases on the system, input of data, generation of reports, correction of errors, and case closure off the system.
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Ongoing safety review at a case level and aggregate level in the clinical studies. Conduct and report periodic/ad-hoc aggregated local safety review and signal detection activities in collaboration with global counterparts.
ExpandApply NowActive JobUpdated 12 days ago - UpvoteDownvoteShare Job
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Establishes on-going dialogue with payor case managers and provider disciplines (e.g., nurses, physical therapist, occupational therapist, speech therapy, social worker). Evaluates clinician’s performance for annual performance review process, at the request of the Clinical Field Manager.
ExpandApply NowActive JobUpdated 6 days ago - UpvoteDownvoteShare Job
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Enters data into the clinical software system related to pre-authorization requests for pharmacy, non-pharmacy, case management and hospitalizations. Work collaboratively with the case management/ utilization management teams, and other customers internally and externally to meet the needs of the population.
Full-timeExpandApply NowActive JobUpdated 9 days ago - UpvoteDownvoteShare Job
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As the domain expert for cybersecurity, you will provide leadership oversight and guide the team throughout new product's development phases, review of product security requirements and recommendations of security design solutions, complete quality documentation, threat modelling, penetration testing, software architecture review and design recommendations, code analysis and other security testing work as needed.
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Review and development of written materials including clinical trial protocols, Informed Consent Forms, Case Report Forms, adverse event (AE)/ serious adverse event (SAE) reporting forms, Clinical Study Reports, and Investigator's Brochures (including Reference Safety Information determinations.
$85Full-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Ability to review, handle, and maintain confidential case information in a reliable and secure manner. JOB SUMMARY: Researches legal issues arising in any of the types of cases heard in the domestic relations, probate, civil, criminal, and juvenile divisions of Circuit Court; prepares memos outlining the legal research and/or prepares opinions or orders as requested by the Judge; drafts proposed orders for the court's review and approval; ensures attorney submitted orders are accurate and filed in a timely manner.
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Reviews and conducts research for ROI (Release of Information) Reviews new cases and conducts research of pertinent laws Edits previously submitted final decisions and writes/researches legal opinions on newest case Edits and reviews cases for issuance Responds to citizen letters Reviews AMICUS briefs Briefs attorneys regarding legal issues, theories and draft statement of facts.
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Certified Case Manager (CCM) or Certified Professional in Utilization Review/Utilization Management/Healthcare Management (CPUR , CPUM, or CPHM) preferred. Managed care payor experience a plus either in Utilization Review, Case Management or Appeals.
$30.85 - $46.28 an hourPart-timeRemoteExpandApply NowActive JobUpdated 30 days ago
review case jobs
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