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Monitors the utilization, quality and costs of independent appraiser, adjusters, alliance partners and others in accordance with established quality, service, and budgetary guidance. Responsible for member service, paying what we owe, controlling expenses, employee engagement, quality, operational risk, and compliance across multiple MSTs. Executes and influences claim’s strategies and plans.
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Preferred: 2 years experience in Utilization Review, Discharge Planning and Medical Case Management in a hospital setting. The Registered Nurse / RN Transitional Care Manager facilitates discharge planning and post acute care services for patients with diagnosis of Congestive Heart Failure, Acute Myocardial Infarction and Pneumonia.
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Assist with review of audit findings from the Defense Contract Audit Agency(DCAA),and assist with research to support the Contracting Officer's final determination, preparing draft responses, and correspondence for Contracting Office approval.
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This Registered Nurse / RN Case Manager coordinates care and services, of selected patient populations, specifically with CHF, AMI, and PN. Registered Nurse / RN Case Manager designs plan of care to avoid patterns of frequent acute hospital or emergency department use, readmissions, and health status decline.
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Experienced Document Review Attorney – Remote. Great opportunity for l icensed attorneys with document review experience interested in quality focused e-Discovery. At least 18 months of prior document review experience.
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You are also encouraged to review all Electrical engineering positions available on our website and apply directly to specific openings which interest you. Key Words: Electrical, Revit, Electrical Design, Power Distribution, Lighting, Controls, Sustainable, Telecommunication, Buildings, Power Systems, Lighting Design, Relays, Electrical Wiring, Electrical Code, Low Voltage, High Voltage, Medium Voltage, Building Electrical Power, Signal Design, Fire Systems, Communication Systems, Electrical Building Systems, Security Systems, NEC, National Electrical Code, SKM, LEED, PLC, SCADA, AutoCAD, MEP.
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ManTech's utilization of any external recruitment or job placement agency is predicated upon its full compliance with our equal opportunity/affirmative action policies. Currently, ManTech is seeking a motivated, career and customer-oriented Salesforce/ServiceNow Developer to join our team.
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Prior authorization/Utilization management experience. Experience with MCG and Milliman guidelines. Active LVN/LPN License. Prior authorization/Utilization management experience. An operating company of Allegis Group, the global leader in talent solutions, Actalent launched as a new specialized engineering and sciences services and workforce solutions brand in 2021.
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Review and approve Land personnel time and expense reports for completeness and accuracy. - Assure that all Land personnel are orientated as they are assigned to the project; orientates personnel to project polices, guidelines, procedures, safety, and emergency response; Assigns tasks to Land personnel and review requirements for documentation of those tasks.
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QA/QC review of CAD drawings and documents prepared by Survey Technicians. Prepare and/or review easement documents. The more successful candidate will be proficient user of Autodesk Civil 3d, Carlson Survey, MicroStation and GeoPak, Trimble Business Center, and Microsoft Office product.
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Manage entitlement and site selection, due diligence review, underwriting, and approvals for proposed new land acquisitions. Job Description David Weekley Homes is seeking a Land Acquisition Manager to join our San Antonio team.
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Partner with DevOps Engineering leadership to set and review SLOs, SLAs, and SLIs, and continuously improve the on-call incident response process. Strong experience with Infrastructure as Code, such as Terraform, Ansible, Chef, or Puppet.
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The Case Manager performs reviews of all inpatient admission records to ensure proper utilization of hospital resources and determination of admission for appropriate level of care. Professional disciplines of the designated case manager may include occupational therapist (OT), physical therapist (PT), registered nurse (RN), respiratory therapist (RT), speech therapist (ST), or (licensed) social worker (LSW.
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Schedules, or assists in scheduling, Admission, Review and Dismissal (ARD) meetings and notifies parents of the ARD meeting, including distributing of ARD calendar to appropriate ARD Committee members in a timely fashion; ensures that Individual Transition Plan elements are completed in the applicable cases; notifies all appropriate school personnel of ARD meeting/ARD schedule changes.
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Assist in the analysis of reports, maps, drawings, aerial photographs, perform site visits, and review survey data to plan and assemble construction documents. Conduct preliminary engineering evaluations and studies to identify design improvement alternatives, compare options, and assist in making design recommendations as it relates to [ select as appropriate: water conveyance systems, water pumping stations, wastewater collection systems, wastewater treatment facilities.
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utilization review jobs Company: University Health System San Antonio in San Antonio, Holdrege, Nebraska
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