- Evolent (Helena, MT)
- …for the culture. **What You'll Be Doing:** **Cardiovascular Utilization Management Reviewer (Interventional Cardiologist)** Are you ready to make a meaningful impact ... interventional cardiology to help ensure the delivery of high-value, evidence-based case reviews. Enjoy improved work-life balance while contributing to better… more
- Entergy (The Woodlands, TX)
- …Entergy's SGP and project management standards; serves as a SGP Gate Reviewer . + Conducts training on the Entergy SGP, project management standards/implementation ... earned/actual progress and conclude on possible impacts. + Supports the SGP Gate Reviewer analysis by providing data on cost, schedule, progress, risk and processes.… more
- Entergy (New Orleans, LA)
- …Entergy's SGP and project management standards; serves as a SGP Gate Reviewer . 3. Conducts training on the Entergy SGP, project management standards/implementation ... progress and conclude on possible impacts. 7. Supports the SGP Gate Reviewer analysis by providing data on cost, schedule, progress, risk and processes.… more
- Sharp HealthCare (San Diego, CA)
- …in risk management reviews. + Assists in pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit review ... findings in conjunction with the Quality Improvement Director. + Assists in POS/PPO Case Management and high-cost review with CMO and Claims management teams.… more
- M&T Bank (Amherst, NY)
- …debtor(s), restrains accounts as appropriate by applying proper exemptions and preparing case file as appropriate. Processes complex legal papers, such as court ... orders and temporary restraining orders. **Primary Responsibilities:** + Monitor work flow and serve as liaison between assigned Item Processing & Deposit Services unit and management. + Provide training and coaching to assigned Item Processing & Deposit… more
- UnityPoint Health (Cedar Rapids, IA)
- …stay issues and level of care changes for compliance + Documents the case management plan to include: clinical needs, barriers to quality care, effective utilization ... of resources and pursues denials of payment and referrals in a timely, legible manner. + Collects appropriate data, trends, analyzes and reports on patterns of care, possible avoidable delays in transition, variance from pathways and resource utilization… more
- Health Advocates Network (Harrisburg, PA)
- …at least twenty (20) hours per month. Demonstrate an understanding of utilization review processes. Basic computer skills to include, but not limited, to Microsoft ... Products. Role Description: Resource in this position will serve as a physician reviewer for the Department of Public Welfare. Resource will provide utilization and… more
- State of Indiana (Indianapolis, IN)
- …legal research that fully addresses a taxpayer's appeal. You will also serve as a reviewer for DOR's written documents and as a resource person - either as an ... various program and legal areas. + May oversee, draft, review , or provide legal advice relating to contracts. +...+ Demonstrated knowledge and ability to apply relevant statutes, case law, and rules. + Ability to effectively communicate… more
- Sharp HealthCare (San Diego, CA)
- …rev1ew process. + Participates in risk management, pharmacy utilization management, catastrophic case review , outreach programs, HEDIS reporting, site visit ... achieve selected utilization/cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations. + Participates in the… more
- Internal Revenue Service (Washington, DC)
- …As such, the Senior Counsel must perform a variety of duties that may involve case or project work in which the Senior Counsel is responsible for personally carrying ... out. This includes complex research, advisory, analysis, and review functions to handle and resolve specific cases or complicated issues. These cases and issues can… more