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Qualifications Masters Degree preferred; minimum Bachelors Degree in Psychology or related Human Service Field or RN. Knowledge of Utilization Review Processes, insurance plans, mental health and chemical dependency treatment.
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This position is responsible for timely review of request for post-acute services and based on established clinical guidelines and/or coverage benefits limitations, determine appropriateness of requested services.
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Lead Tenet Utilization Review Teams market structure and operations management to effectively support utilization review and authorization confirmation functions to promote an appropriate level of care and prevent payer denials.
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This role offers you the chance to make a significant impact on our digital asset management and copy review process. Familiarity with regulatory requirements for copy review in the life sciences industry.
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The Commercial Credit Review Senior Manager is responsible for executing an independent, risk-based assurance review of assigned platforms within Capital One Bank’s commercial credit portfolio, including assessment of credit practices, effectiveness of policy implementation and risk rating accuracy.
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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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An RN with a bachelor’s degree in Business, Health Care Administration or equivalent on the condition that they enroll in a BSN program within one year of employment and complete the BSN within three years of employment OR Master’s Degree in Social Work, Counseling Psychology, Clinical Psychology, Family and Marriage Therapy, Mental Health Counseling, Health Administration, or other related fields.
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Enforce City of Atlanta Stream Bank Buffer requirements, review for and enforce State of Georgia Stream Bank Buffer requirements, coordinate with other agencies as necessary, e.g. Georgia Department of Natural Resources, Georgia Soil and Water Conservation District.
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Review Project with Controller & Project Accountant - Project Duration, Scope, Heavy Job Reporting Format, Davis-Bacon Wages, Per Diem needs, Billing Cycle, Project Budget, Profit Goals & Project Risks - Can be handled during turn over meeting.
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Key words: real estate paralegal, commercial title review, reviewing surveys, review surveys, drafting deeds, commercial escrow officer, closing agent, closing officer, commercial title officer, commercial escrow agent, reviewing titles, review titles, commercial loan underwriter, commercial examiner, commercial loan examiner.
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Conduct individual face-to-face sessions with each Support Coordinator to review individual cases on a weekly basis. Review ten percent (10%) of each Support Coordinator's case records monthly for completeness, compliance with these standards, and quality of service delivery.
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The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services.
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5-7 years Loan Review, Commercial Lending, Credit Administration or Regulatory Examination. 7-10 years Loan Review, Commercial Lending, Credit Administration or Regulatory Examination. Under the direction of a senior Loan Review officer, participate in discussions with affiliate management regarding loan grading and conclusions regarding credit underwriting, approval, and administration.
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As a member of the CPRT team, the Vice President will provide independent review and challenge across the capital management and planning continuum encompassing business-as-usual capital management, ongoing and quarterly business and capital planning forecasts (including CCAR/DFAST.
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Assist plan review staff with the plan review processes; review structural, non-structural, and other plans for code compliance; review construction plans and assure compliance with building codes.
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review job Title: manager clinical rn Company: Childrens National
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