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Reporting to the CMRS Manager, the Case Management Resource Specialist (CMRS) works collaboratively with the Discharge Planning RN Case Managers; providing direct administrative support to the discharge planning processes and to the department.
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Minimum of 3 years utilization review and/or appeals and grievance experience either with a health plan or health care facility. The Clinical Appeals and Grievance Coordinator (RN) is an integral part of our Appeals and Grievance review process.
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Assess tenants on their tenancy, substance abuse issues, mental health symptoms, legal issues, health care, employment and income, independent living skills, and community engagement using the Phases of Care (POC) Assessment Tool to guide frequency and type of case management intervention.
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Reporting to the Ambulatory Administrative Director, the ambulatory Practice Operations Manager is responsible for the direct management of the surgical scheduler staff, indirectly the ambulatory support staff and operational management of the Operating Room (OR) for Gynecology (GYN) surgical divisions within the Department of Obstetrics and Gynecology.
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The position requires a high degree of flexibility, independence and willingness to participate in multiple activities and provide support to all members of the Case Management Department.
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Key Words: RN Travel, Travel Nurse, Contract Nurse, Agency Nurse, Travel Contract, Travel Nursing, Case Manager, Case Management, Utilization Review, Case Manager RN.
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Demonstrates extensive abilities and/or a proven record of success assisting practice management, emphasizing partial or full management of client engagements involving the evaluation and enhancement of clients' indirect tax processes and/or systems to get better control over data and manage costs, including: State and local tax sales and use tax laws, regulations, policies and procedures.
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Extensive knowledge of regional and national payer landscapes with expertise in formulary decisions, reimbursement policy, utilization management criteria, prior authorization processes and appeal requirements.
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Some of the cases that the Public Utilities Engineer play a key role in are safety compliance, storm and emergency response, service quality, system performance and reliability, vegetation management, interconnection of distributed generation, grid modernization, and cost prudency and review.
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Responsibilities: Perform / lead independent review and model validation of wholesale credit risk and compliance risk models including PD, LGD, Loss forecasting, AML, Fair Lending, Fraud Detection, and other business or operational related models.
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Hands on support, knowledge, and utilization of a variety of investment system applications including: performance measurement system (Black Diamond), investment analytics and other related investment applications (FactSet and Bloomberg.
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Audit Planning Internal Audit Review Issue Management Risk Management Automation Business Acumen Project Management Technical Documentation Coaching Relationship Building Minimum 3 years of audit experience in areas related to AML, sanctions and fraud risk management programs and regulations, banking regulations, local standards, and internal policies.
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The Wellness Coordinator works in partnership with housing staff to engage residents in wellness assessments and health education programs, connect residents to needed services, provide a wide variety of case management tasks, ensure that all interventions are documented and tracked and to develop and strengthen partnerships with community provider organizations as needed.
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As the Associate Director of Veeva System, Promotional Review and Operations (PRO) at Alexion, you will be integral in ensuring the seamless management of our material review system and processes.
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The ideal candidate will handle a variety of tasks related to subrogation, including intake, review, active management of discovery, mediation, trial, and the management of numerous claims annually.
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management utilization review case rn jobs Title: travel rn Company: Medical Solutions in Boston, AZ, Australia
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