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As a part of the Utilization Management team the Utilization Review RN is a member of the Care Coordination team. Utilization review, prior authorization, Care management, Case management, interqual, ncqa, ncqa standards.
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Under the direction of the VP of Case Management & Continuing Care, the Sr. Director of Utilization Review (UR) is responsible for overseeing the development, implementation, and performance management of Utilization Review services performed across the Tenet enterprise.
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The Litigation & Practice Technology ("LPT") Project Manager reports to the Associate Director and will work directly with case teams when requested by case teams and clients to: identify eDiscovery focused technical requirements and resources; assist with managing and selecting service providers; define and execute associated support tasks; provide project management for technical workstreams; and when requested provide eDiscovery and analytics consulting services.
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Provide hands-on support in Relativity, Brainspace and other litigation technology toolsets for a variety of requests, including: case creation; field and coding layout creation; strategic application of TAR and other analytics; advanced search design, implementation and validation; creation and support of document review and production workflows; privilege log design and management; complaint data and exhibit management.
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Provide briefings to the Associate Director and Director of Litigation & Practice Technology as requested. A minimum of 3 years of hands on experience with leading eDiscovery review platforms (Relativity, DISCO, Recommind) with an emphasis on database setup, complex search construction and results validation, design of optimized review workflows including document batching.
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As one of the world's leading law firms, we serve a broad range of clients with market-leading practices in private equity, M&A and other complex corporate transactions; investment fund formation and alternative asset management; restructurings; high-stakes commercial and intellectual property litigation; and government, regulatory and internal investigations.
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External DescriptionPosition DetailsThe Blended Case Management Supervisor is responsible for assuring that the DBH Practice Guidelines are put into operation to the extent possible within the general operations of the TCM duties.
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Participate in producing well written reports and presentations to relevant review bodies, including senior management in order to defend conclusions and present any findings. Quantitative skills in the areas of structured finance, credit derivatives, default and recovery modeling, and / or credit risk management.
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Team members typically specialize in either model validation or criteria validation/credit review but will have the opportunity to develop skills and experience across both disciplines. Conduct validation and credit review activities using both qualitative credit skills and statistical / quantitative analyses in the evaluation of ratings performance.
$58,300 - $115,850 a yearFull-timeExpandApply NowActive JobUpdated 14 days ago - UpvoteDownvoteShare Job
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The Director of Loss Mitigation is responsible for the Credit administration of Northwest's criticized and classified assets, Classified Asset review and impairment analysis, as well as oversight of the Bank's retail and commercial collections activities.
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The Utilization Review coordinator performs activities which support the Utilization Management functions. They are responsible for the delivery of the Utilization Management process including but not limited to: making clinical recommendations regarding medical necessity for admission and continues stay, screens patients for client specific guidelines regarding insurance, Medicare and/or Medicaid guidelines, send payor specific Notice of Admission and continued stay reviews.
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Utilization Review RN Case Management. As a Utilization Review Nurse/Integrated Care Manager RN with Sentara, you work together intensely with the patients, families, and members of the medical team to provide patients with the resources they need and help prevent them from being readmitted to the hospital.
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As a Specialist, you will be supporting the knowledge management activities of BCG US Federal Government cases (Public Sector Practice Area). Content Review activities such as regularly checking and updating Public Sector Practice Area / US Federal Government related content as per metadata guidelines and content quality checklist.
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Providence Medical Group (PMG) is seeking a full-time Family Medicine Physician to join team a well-established practice at PMG Gresham. Youll be part of an integrative primary care team including an embedded APP who will support your panel and In Basket management, a behavioral health provider, clinical pharmacist, diabetes educator, and case management team.
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This position partners with Lines of Business and other Risk/Compliance/Audit and Security areas to create, implement, maintain, review, and oversee an effective third-party risk management program and framework.
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review practice management jobs Title: medical director Company: Meet
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