• RN Utilization Review - System Care…

    Guthrie (Binghamton, NY)
    Provides health care services regarding admissions, case management, discharge planning and utilization review . Responsibilites: Reviews admissions and service ... medical necessity and/or compliance with reimburesement policy criteria. Provides case management and/or consultation for complex cases. Assists departmental staff… more
    Guthrie (07/05/25)
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  • Government Analyst II

    MyFlorida (Tallahassee, FL)
    …. Requisition No: 860920 Agency: Commission on Offender Review Working Title: GOVERNMENT ANALYST II - 78003000 Pay ... Government Analyst II - CS FLORIDA COMMISSION ON OFFENDER REVIEW Internally Agency The Florida Commission on Offender Review more
    MyFlorida (09/13/25)
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  • Senior Consultant, National Federal Tax Services,…

    Deloitte (Detroit, MI)
    Senior Consultant - National Federal Tax Services - Strategic Tax Review (STR) Do you have excellent tax compliance skills and a strong desire to join a cutting-edge ... up of multiple tax service offerings including Strategic Tax Review , Inventory Tax Services, and Meals & Entertainment ...are dependent on the facts and circumstances of each case . A reasonable estimate of the current range is… more
    Deloitte (08/27/25)
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  • Tax Manager, Strategic Tax Review

    Deloitte (Los Angeles, CA)
    …facts patterns and laws, regulations, cases and administrative guidance. + Comprehensive review of information to understand a Client's business and its tax returns. ... up of multiple tax service offerings including Strategic Tax Review , Inventory Tax Services, and Meals & Entertainment ...are dependent on the facts and circumstances of each case . A reasonable estimate of the current range is… more
    Deloitte (08/21/25)
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  • RN Peer Review Specialist

    Sanford Health (WI)
    …use in Medical Staff peer review processes and activities to include case review , Ongoing and Focused Professional Practice Evaluation, and evaluation of ... **Salary Range:** $31.00 - $49.50 **Job Summary** The Peer Review Specialist facilitates provider peer review processes...The Peer Review Specialist facilitates provider peer review processes at a regional level. Assists in the… more
    Sanford Health (08/19/25)
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  • RN Quality Review Nurse Home Health

    AdventHealth (Orlando, FL)
    **Population Health Case Manager (RN) AdventHealth Home Health** **All the benefits and perks you need for you and your family:** + Benefits from Day One + Paid Days ... ST, Orlando, FL, 32804 **The role you'll contribute:** The Population Health Case Manager (PHCM) ensures effective utilization and case management oversight… more
    AdventHealth (09/10/25)
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  • Carpenter (Discrete Review Posted Basic…

    Huntington Ingalls Industries (Pascagoula, MS)
    CARPENTER (DISCRETE REVIEW POSTED BASIC QUALIFICATIONS) Location: Pascagoula, Mississippi, United States Date: Sep 8, 2025 Req ID: 42440 Team: 10 Carpenters Entity: ... your request and your contact information. Reasonable accommodations are considered on a case -by- case basis. Please note that only those inquiries concerning a… more
    Huntington Ingalls Industries (09/10/25)
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  • Special Investigation Unit Lead Review

    CVS Health (Harrisburg, PA)
    …insured's, providers, claimants, etc. - Researches and prepares cases for clinical and legal review . - Documents all appropriate case activity in case ... tracking system. - Prepares and presents referrals, both internal and external, in the required timeframe. - Facilitates the recovery of company lost as a result of fraud matters. - Assists team in identifying resources and best course of action on… more
    CVS Health (08/20/25)
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  • Utilization Management Nurse Consultant - Medical…

    CVS Health (Salt Lake City, UT)
    …a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and plan language ... thinking, evidenced based clinical criteria and clinical practice guidelines. Med Review nurses use specific criteria to authorize procedures/services or initiate a… more
    CVS Health (09/13/25)
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  • Medical Claim Review LVN/LPN (CA LVN…

    Molina Healthcare (Rochester, NY)
    …implementation of proactive approaches to improve and standardize overall retrospective claims review . * Ensures core system is updated correctly to process claim.. ... Minimum three years clinical nursing experience. Minimum one year Utilization Review and/or Medical Claims Review . **Required License, Certification,… more
    Molina Healthcare (09/12/25)
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