• Nurse Reviewer I (US)

    Elevance Health (Grand Prairie, TX)
    **Nurse Reviewer I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in person training sessions, ... and ensures essential face-to-face onboarding and skill development. The **Nurse Reviewer I** will be responsible for conducting preauthorization, out of network… more
    Elevance Health (05/28/25)
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  • Nurse Reviewer I

    Elevance Health (Grand Prairie, TX)
    **Nurse Reviewer I** **Location:** Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, ... and ensures essential face-to-face onboarding and skill development. The **Nurse Reviewer I** will be responsible for conducting preauthorization, out of network… more
    Elevance Health (05/22/25)
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  • Credit Risk Review Advisor Senior…

    PNC (Houston, TX)
    …or issues.Participates in continuous monitoring for assigned portfolios. + Oversees file review activities of reviewers as Reviewer in Charge for assigned ... success. We are looking to hire a Credit Risk Review Advisor Senior in Credit Risk Review ...credit exposures. You may have responsibility of being a Reviewer in Charge. The Reviewer in Charge… more
    PNC (05/09/25)
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  • Physician Quality Assurance Manager SSA

    Chenega Corporation (San Antonio, TX)
    …Management + Review trainee case adjudications for quality assurance. + Review a percentage of Independent Case Reviewer (ICR) case adjudications for ... **Summary** **C2 ALASKA, LLC** Telework The **Medical Quality Assurance Manager ** shall train and report on the work progress...reviews must uphold the requirements for a policy compliant review as per the Independent Case Reviewer more
    Chenega Corporation (03/05/25)
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  • Senior Manager , Commercial Credit…

    Capital One (Plano, TX)
    …of hours to be regularly worked. Charlotte, NC: $175,500 - $200,300 for Sr. Credit Review Manager McLean, VA: $193,000 - $220,300 for Sr. Credit Review ... Manager New York, NY: $210,500 - $240,300 for Sr. Credit Review Manager Plano, TX: $175,500 - $200,300 for Sr. Credit Review Manager Richmond, VA:… more
    Capital One (05/25/25)
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  • Non-Clinical Coding and OASIS Review

    BAYADA Home Health Care (Austin, TX)
    …full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices ... about BAYADA Benefits, click here (https://www.bayada.com/benefits/) . **Responsibilities:** + Review clinical information for appropriateness, congruency, and accuracy as… more
    BAYADA Home Health Care (05/17/25)
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  • Manager , Consulting - Legal Bililing…

    Wolters Kluwer (Houston, TX)
    …and Director. You will supervise and lead a group of 8+ legal bill review analysts ("Team") within the LBACOE and ensure that their Team's workflow meets and/or ... analysts; (2) training new LBACOE invoice analysts on approved legal billing review techniques and platforms; (3) assessing the training needs of LBACOE invoice… more
    Wolters Kluwer (05/14/25)
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  • Clinical Coding and OASIS Review

    BAYADA Home Health Care (Austin, TX)
    …Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, ... match, direct deposit, and employee assistance program **Responsibilities:** + Review clinical information for appropriateness, congruency, and accuracy as it… more
    BAYADA Home Health Care (05/17/25)
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  • Case Manager and Utilization Review

    Scottish Rite for Children (Dallas, TX)
    …committed to giving children back their childhood! Job Posting Title: Case Manager and Utilization Review Coordinator Location: Dallas - Hospital Additional ... personnel regarding applicable federal, state and local regulations + Provide concurrent review and follow up with appropriate personnel regarding denials + Collect… more
    Scottish Rite for Children (05/23/25)
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  • Senior Project Manager

    Terracon (San Antonio, TX)
    …deliver work products to satisfaction of client. Coordinates effort with Authorized Project Reviewer (APR) to make sure that APR has opportunity to engage throughout ... a large scale and complex project. + Works with client or National Account Manager (NAM) to define project scope, schedule and budget + Leads interactions with… more
    Terracon (05/06/25)
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