- Wittenberg Weiner Consulting LLC (Santa Fe, NM)
- …to FEMA guidelines. Claims Reviewers - Senior (Team Lead) will objectively review , investigate, process, evaluate third-party claims and supervise a team of claims ... Diploma. + A minimum of ten years of combined experience in claim/ case processing roles including customer service, data entry, reviewing, and evaluating various… more
- Catholic Health (Buffalo, NY)
- …Must possess strong interpersonal skills necessary to work with medical staff, case management, patient care services, ancillary and support departments + Strong ... critical thinking, analytical and problem solving skills WORKING CONDITIONS + Must be flexible and demonstrate ability to adapt to stressful work environment REQNUMBER: 38071 more
- City of New York (New York, NY)
- …for one (1) Principal Administrative Associate III to function as a Quality Control Case Review Supervisor who will: - Supervise and provide guidance to Quality ... the Enhanced Quality Assurance System (EQAS) or the State Case Review units. Provide guidance and clarification...are in compliance with the State. - Train QC Case Reviewer on these rules and procedures… more
- City of New York (New York, NY)
- …Support Services (OCSS) is recruiting four (4) Clerical Associate III's, functioning as Case Review Specialists, Under supervision of the Unit Supervisor of Data ... latitude for independent judgment, the Clerical Associate III, functioning as Case Review Specialist, is responsible for reviewing reports to correct and… more
- Beth Israel Lahey Health (Burlington, MA)
- …a job, you're making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse **Job Description:** The Inpatient Registered ... team to ensure a timely process. Registered Nurses (RNs) with utilization review experience, case management experience, and med/surg experience are encouraged… more
- City of New York (New York, NY)
- …for (1) one Principal Administrative Associate, who will function as a Medicaid Quality Control Case Review Supervisor who will: - Review the audit findings ... review of completed assignments to ensure consistency in case error finding methodology. - Train and update Quality...capture the elements necessary to assist the Quality Control Case Reviewers in their eligibility review findings.… more
- Houston Methodist (The Woodlands, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) PRN position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... medical record review for medical necessity and level of care using...coverage determinations (LCDs & NCDs). This position collaborates with case management in the development and implementation of the… more
- Covenant Health (Nashua, NH)
- …+ Maintains/enhances professional development/skills required to function as a Utilization Review Case Manager + Completes all mandatory learning assignments ... the health care team. + Annual goals are achieved. + Attends pertinent case management/utilization review programs to maintain current knowledge of UR practices.… more
- Children's Hospital Boston (Boston, MA)
- …Hours per Week:1 Job Posting Category:NursingJob Posting Description:Department Summary: The UM Case Managers at Boston Children's review documentation within 1 ... to manage utilization trends, collaborating with the hospital's discharge planning case managers, healthcare team, and Patient Financial Services. They are part… more
- LifePoint Health (Hickory, NC)
- *Registered Nurse (RN), Clinical Case Manager* PRN * * *Your experience matters* At Frye Regional Medical Center, we are driven by a profound commitment to ... of care management as prescribed in the initial Utilization Review Plan with regard to resources, appropriateness of care...Stay (GLOS) for each patient. Reports to: Director of Case Management * * *ESSENTIAL FUNCTIONS* *1. Departmental Leadership… more