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Minimum three years progressive professional experience in health care, including a minimum of two years in a grievance and appeals or related area such as medical or utilization management required.
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VNS Health is seeking a Registered Nurse (RN) Clinic Utilization Review for a nursing job in Secaucus, New Jersey. Collaborates with professionals, health plan departments such as Claims and Medical Management, and the third party administrator staff and legal, as necessary, to investigate and facilitate resolution of individual grievances and appeals.
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Provides first level RN review for all outpatient and ancillary prior authorization requests for medical appropriateness and medical necessity using appropriate criteria, referring those requests that fail review to the medical director for second level review and determination.
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The Utilization Management Coordinator is responsible for all utilization management activities for assigned cases from admission through discharge, including peer reviews and appeals, in accordance with the Utilization Review Plan, for patient population ages 5 years through 21 years, with significant behavioral health needs and Autism Spectrum Disorders or other developmental disorders.
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Position is hybrid, 2 days remote and 3 days in-office in Manhattan, NY. Qualified candidates must have NYS-RN License or NYS-LMSW License, UAS-NY Certification and previous supervisory experience, RN or LMSW Managed Care Care Management, Documentation Review and MLTC experience.
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Manage the risk and exposures within their portfolio on an ongoing basis, using the various credit risk management and product monitoring systems within Deutsche Bank, including internal stress test information, exposure data and performance/portfolio data received on a regular basis from hedge funds.
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Acts as the primary resource for the business regarding review and management of legal matters relating to structured finance / securitization, commercial and commercial real estate (“CRE”) lending and whole loan trading transactions.
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Review monthly and quarterly NAV packages, including cash and position reconciliations, capital allocations, calculation of management fees and waterfall calculations and investor account statements prepared by fund administrators.
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The Utilization Management Appeals Nurse performs daily appeal reviews and clinical quality oversite. Job Title: Utilization Management Nurse, Quality & Appeals. in Utilization Review process including benefit interpretation, contract language, medical and policy review.
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Primary duties of the Trash Collector include: - Operating garbage trucks - Collecting and dumping trash receptacles - Following route assignments as directed Waste Management offers an excellent benefits package that includes medical, dental, vision, life, 401(k) savings and more.
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Third Party Risk Management Lifecycle & Implementation of TPRM Second Line Review. Assist with RACA quarterly review in the expertise of third party risk management. Work with other SMEs under the third party risk management framework to ensure the third party risk management activities are efficient.
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Teams: Credit Risk, Enterprise Risk, Liquidity Risk, Market Risk, Model Risk, Operational Risk, Risk Engineering, Corporate Risk, Credit Review Group. Embedded in everything we do, risk management is key to effectively identifying, monitoring and anticipating the diverse array of risks the firm faces in serving clients and operating its global businesses, including credit risk, market risk, liquidity risk operational risk and model risk.
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Established in 1975, ICE offers award-winning six to 13-month career training programs in Culinary Arts, Pastry & Baking Arts, Health-Supportive Culinary Arts, Restaurant & Culinary Management, and Hospitality & Hotel Management, in addition to professional development in Artisan Bread Baking, The Art of Cake Decorating and Intensive Sommelier Training — with more than 14,000 alumni, many of whom are leaders in the industry.
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Review subsidy applications for completeness and accuracy prior to submission to property management and HPD. Determine vacancy priorities and ensure timely filling of vacancies coordinating with funders, property management and program staff.
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Here are the essential duties and responsibilities for the VP of Asset Management - Specialist Assets…Manage borrower relationships on a portfolio of delinquent and/or distressed multifamily and healthcare mortgage loans including balance sheet, participated, and securitized deals.
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review management jobs Title: director Company: Meet in Newark, NJ
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