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The Utilization Review Specialist will also perform pre-certification reviews, concurrent reviews and will perform appeal reviews as needed. Three to Five (5) years experience in Case Management/Utilization Review (as either CADC, LAADC, LCSW, LMHC, LMFT, or Utilization Review Coordinator.
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The Physician will be assigned to provide weekly review and oversight of blood glucose management of patients with diabetes mellitus (types 1 and 2), as well as initial consults on patients admitting with diagnoses such as diabetes mellitus, thyroid disease, growth hormone deficiency, and other conditions including but not limited to Turner’s Syndrome, cystic fibrosis-related diabetes, and inborn errors of metabolism.
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Coding, Charge Review, Charge Entry, Denials Review if needed. Minimum of 3 years’ experience in coding audit or quality review work - REQUIRED. This is a fully remote position.
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Performs prior authorization, precertification, and retrospective reviews and prepares decision letters as needed in support of the utilization review contract Assists management with training new Nurse Reviewers to include daily monitoring, mentoring, feedback and education.
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Understanding of ICD10 Coding in relation to DRGsAbstract additional data elements during the chart review process when coding as neededUtilize technical coding principals and MS-DRG reimbursement expertise to assign appropriate ICD-10- CM diagnoses and ICD- IO-PCS procedures.
$44.13 - $52.7 an hourFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Associate Medical Director will, as permitted by applicable law and consistent with Associate Medical Director’s clinical judgment, order any necessary scheduled narcotic or other scheduled medications needed for WellBe patients in collaboration with the WellBe Senior Medical Advanced Practice Clinicians during the time said Advanced Practice Clinicians are awaiting appropriate credentials from the U.S. Governmental Drug Enforcement Agency.
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Core skills needed are Java, Spring Boot and Python. This investigation includes but is not limited to a criminal, civil litigations and regulatory review, employment, education, and credit review (role dependent.
$85,000 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The Role Own every aspect of the sales process from greeting the customer to delivery Review, update and manage daily inventory reports and prepare and review monthly plans with sales leaders Create and execute strategies for increasing market share REQUIREMENTS- Previous auto sales associate experience is NOT REQUIRED for this position, PROFESSIONAL SALES TRAINING WILL BE PROVIDED.
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Job Types: Full-time, Part-time, ContractSalary: $70.00 - $120.00 per hourMedical specialties: EndocrinologyInternal MedicinePrimary Care Standard shift:Day shiftEvening shift Weekly schedule:Monday to FridayWeekends as needed Work setting:RemoteTelehealth Application Question(s): Are you currently licensed to practice as an MD (Doctor of Medicine), DO (Doctor of Osteopathic Medicine), FNP (Family Nurse Practitioner) in a minimum of ten states.
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While not a principal focus of this role, project efforts may require collaboration with key teams typically outside of the revenue cycle, such as care management, utilization review, population health, and other key areas as needed.
$122,100 - $234,700 a yearFull-timeRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We also offer a flexible, remote work environment. This remote-based position will spend the majority of the time auditing coders, educating coders, and working on various projects that involve coding and education.
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For all matters on which the Corporate Counsel, Litigation is staffed, this attorney will be responsible for leading all discovery strategy and execution: This includes review of all discovery requests and responses, overseeing collection and review of documents, and identification and preparation of company witnesses to testify in depositions or other proceedings as needed.
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Review audit requests from external regulatory and accrediting bodies; provide guidance to Compliance Office team members regarding responses and appeals; negotiate with payors and government entities as needed in collaboration with the Chief Compliance Officer, Division Director, Compliance, and the Legal Services Office as needed.
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Consult with the following UCF offices and staff regarding compliance approvals: Institutional Animal Care and Use Committee; and Facility Security, as needed. May coordinate contract negotiations with UCF Research Foundation, as needed.
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You will utilize expert nurse software to review all dashboard entries and alerts, conduct sound nursing assessments, phone triage and video triage (if needed). We are seeking a Remote Registered Nurse Care Center (PRN) to join our team in PA.
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