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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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Plan Review Section review the engineering proposals for various types of projects submitted by different City and State Agencies, Private Developer, Transit/MTA, Port Authority, EDC, etc.
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The Utilization Review Specialist manages daily operations, which include supervising the staff performing benefit enrollments and utilization management activities. The Utilization Review Specialist participates in department development and unit performance improvement.
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General Functions: + Experience and knowledge of clinical guidelines/criteria and the accurate application during a clinical review. + Health plan based utilization review.
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If applicable, answers donor recovery screening questions as needed on an on-call basis on behalf of the DCIDS Tissue Bank Assists in training and mentoring of new Quality Review Coordinators. As needed, meets with the DCIDS Tissue Bank Medical Director(s) to review, and answer questions pertaining to the information and documentation within the donor record.
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The Quality Review Coordinator performs ocular and tissue donor record quality assurance review in compliance with DCIDS, FDA, EBAA, and AATB policies, procedures, regulations, and standards.
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We are currently searching for a high caliber Clinical Review Coordinator to help facilitate the organ donation process by conducting a thorough quality review of medical records.
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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.
$56,614 - $75,451 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Utilization Review Specialist will also coordinate with appropriate discharge planning processes, providing feedback on documentation processes; and functions as a resource to the clinical team regarding approved criteria, practice guidelines and alternative treatment options.
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As the Care Manager RN for Hoag Memorial Hospital, Newport Beach, you’ll be responsible for utilizing your clinical expertise, discretion, and independent judgement to assess patients’ needs and coordinate post-acute care in order to provide for a safe discharge.
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When naviHealth is delegated for utilization management, review referral requests that cannot be approved for continued stay and are forward to licensed physicians for review and issuance of the NOMNC when appropriate.
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Perform clinical screening to determine the expedited review of grievance and appeals. Assist the Grievance and Appeals Department in completing clinical appeals case summaries for submission to the Independent Review Entity, State Hearings and other escalated appeals.
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Experience with electronic document review technology Examples: Relativity, Concordance, ViewPoint, etc. Spanish Document Reviewer Contact Review - Washington, DC Location: Remote Start Date: Negotiable EXPERIENCE & QUALIFICATIONS: Fluency in Spanish Familiarity with document review workflows Examples: Privilege/Responsiveness Review, Redactions, Conceptual Searching, First and Second Review, etc.
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We seek attorneys to assist with document review, privilege review, expert testimony, legal research, and foreign language translation. Unlike other eDiscovery vendors, Contact fosters a culture where every project manager, programmer, engineer, reviewer, and analyst sees themselves as an extension of the projects' team.
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Review aging accounts receivable with Project Controls Specialist and Operation Manager to determine who will follow up with clients for payment status. Meet with Project Controls Specialist and Operation Manager to review, discuss, and resolve issues with invoicing and documentation provided.
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review job Title: manager clinical rn Company: Upmc
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