- Commonwealth of Pennsylvania (PA)
- …duties will include supervising clerical and technical staff in the maintenance of complex medical case histories, organizing and monitoring the integrated ... Medical Records Technician - SCI Fayette Print (https://www.governmentjobs.com/careers/pabureau/jobs/newprint/5145240) Apply Medical Records Technician - SCI… more
- Chenega Corporation (Rockville, MD)
- …Professional Services Strategic Business Unit** company, is looking for a Physician- Contract Medical Reviewer (CMR) to support the Department of Health and ... MD location. + Professional Background: Relevant experience in claims review , healthcare administration, or related fields. + A minimum...+ A minimum of 10 years of professional experience medical consultation support to a busy and complex… more
- Chenega Corporation (Rockville, MD)
- …Services Strategic Business Unit** company, is looking for a Nurse Practitioner-Contract Medical Reviewer (CMR) to support the Department of Health and ... managed care. + Professional Background: Relevant experience in claims review , healthcare administration, or related fields. + A minimum...+ A minimum of five years of professional experience medical consultation support to a busy and complex… more
- APTIM (Santa Fe, NM)
- **Summary:** The Senior-Level Claims Reviewer is responsible for independently reviewing, analyzing, and processing complex claims related to disaster losses in ... on claims interpretation, policy compliance, and documentation quality. The Senior Reviewer also supports mentoring of mid-level staff, provides guidance on… more
- APTIM (Santa Fe, NM)
- **Summary:** The Mid-Level Claims Reviewer supports the claims process by reviewing, evaluating, and documenting claims for disaster-related losses. This role ... needed. **Key Responsibilities/Accountabilities:** + Ability to understand and interpret complex federal policy language, including relevant statutes, regulations, policies,… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …conjunction with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or ... appropriate cases to the Medical Director for review . Refer to and work closely with Case...in improving member and community health. + Manages more complex assignments; cross-trained to review various levels… more
- University of Southern California (Alhambra, CA)
- …services, including transfers to an alternative level of care. As more complex medical treatment options emerge the Case Manager will look to eliminate gaps ... of specific patient populations. The role integrates the functions of complex case management, utilization management, quality management, discharge planning… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …conjunction with Provider Relations, explaining processes for accessing Health Plan to perform medical review , obtains case or disease management support, or ... appropriate cases to the Medical Director for review . Refer to and work closely with Case...in improving member and community health. + Manages more complex assignments; cross-trained to review various levels… more
- BMO Financial Group (Milwaukee, WI)
- …analysis and assessment to resolve strategic issues. + Develops the business case by identifying needs, analysing potential options and assessing expected return on ... and information to provide insights and recommendations. + Manages review findings and follow up in transparency, consistency, detailed...and to find solutions to problems that can be complex and non-routine. + Implements changes in response to… more
- Lilly (Indianapolis, IN)
- …are determined to make life better for people around the world. **Purpose:** The Case Management Medical Review Scientist is responsible for conducting ... comprehensive medical review of Individual Case Safety Reports (ICSRs),...clinical research principles, regulations, and be able to interpret complex situations and assess impact of evolving regulatory environment… more