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Provides training and service recovery with direct reports, including the supervision of the day-to-day activities of subordinates by assigning workload, reviewing retrospective utilization review records prepared for admissions and continued stay reviews, reviewing cases referred to the physician advisor, and providing technical guidance on unusual cases.
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Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care.
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We are hiring a Utilization Review Coordinator to work with medical professionals, payors, and healthcare providers to ensure each patient has access to the appropriate level of care and length of stay to provide them with the best chance at recovery.
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Posted job title: RN Utilization Review Full Time Days About Detroit Medical Center The Detroit Medical Center (DMC) is the leading academically–integrated hospital system in Metro Detroit, and one of the largest health care providers in Southeast Michigan.
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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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Maximus is hiring a Clinical Review Coordinator - RN/LPN (Remote) to support the IN LCAR program. Maximus provides online PASRR Level I and Level II IDD screening and online Level of Care utilization review for long-term care populations across Indiana.
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More specifically, the Capital Planning Review Team ("CPRT") leads the holistic independent review and challenge of the capital management and planning process across the capital planning continuum, and associated policies, procedures, and risk limits.
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Perform effective review and challenge activities for P&L and balance sheet through ongoing interaction with the first line via walkthroughs and dedicated governance meetings. If you are a person with a disability and need a reasonable accommodation to use our search tools and/or apply for a career opportunity review Accessibility at Citi.
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Develop presentation materials and review and challenge templates and memorialize R&C meetings key takeaways. Present observations and results of the review and challenge during CPRTs review sessions.
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Advise, support, and consult with technologists, radiologists, and Radiation Safety Officer (RSO) regarding clinical protocol management, dose assessment, and review of Radiation Protection Program Elements.
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VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Manhattan, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 09/23/2024 Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health.
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Case management, utilization review, or discharge planning experience in an acute, rehabilitation, skilled nursing or outpatient setting is required. Preferred - Health plan experience in utilization review and case management will be considered.
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Avosys is seeking a Bexar County Remote Registered Nurse - Medical Review Specialist to work remotely to review Medicare claims. Perform clinical reviews of Medicare Part A and Part B claims for Medical Review, Redeterminations/Appeals (Appeals), and Prior Authorization requests (collectively, the “Services”) in accordance with CMS (Centers for Medicare & Medicaid Services) requirements.
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Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 09/23/2024 Duration: Ongoing Employment Type: Staff Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines – Managed Long Term Care (MLTC), Medicare Advantage (MA), or Select Health.
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Review warranty policy and procedures with PCNA legal, customer commitment, quality engineering, and technical. Provide warranty claim review for dealer consultations to support PCNA Warranty in ongoing compliance initiatives.
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review job Title: expert Company: Gentech Murtech
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