- YesCare Corp (Brentwood, TN)
- …pre-established review parameters under the direction of the YesCare Medical Director. + Identify and document comparisons with community standards, regionally ... contracts and involved in the implementation of a comprehensive outpatient/inpatient review process utilizing criteria based review standards and standards… more
- City of New York (New York, NY)
- …for day-to-day tracking and coordination of complex and high-risk cases including case review , participation in case conferences, recording next steps ... to rapidly identify and intervene to support clients with complex behavioral health and/or medical issues who...organizations who serve DHS clients. As needed, conduct literature review on homeless health care and interventions targeted to… more
- Lawrence General Hospital (Lawrence, MA)
- …the top of the range to support future salary growth. As the Complex Care Nurse Manager provides evidence-based assessments, tools, information, and resources that ... of patients and their families in settings across the healthcare continuum. The complex care manager utilizes their knowledge of social determinants of health, care… more
- Robert Half Legal (Oakland, CA)
- Description We are seeking a California-barred Document Review Attorney for a fully remote opportunity supporting litigation and compliance projects. This role is ... East Bay area for occasional in-person meetings or onboarding. Responsibilities + Review and analyze large volumes of documents for relevance, privilege, and… more
- City and County of San Francisco (San Francisco, CA)
- …is looking for an experienced and motivated civil litigator to join its Complex & Affirmative Litigation Team. About the Office The San Francisco City Attorney's ... the City Attorney's Office please visit: https://www.sfcityattorney.org/ (about:blank) About the Complex & Affirmative Litigation Team The team is a collaborative,… more
- WestCare Foundation (Henderson, NV)
- …carriers + Read and understand patient/members running chart narrative and respective case notes and be able to disseminate patient needs and professional/clinical ... and/or Bachelors or Masters level CADC/LADC with 2 years utilization review experience, preferred experience working with individuals with psychiatric or substance… more
- USAA (Tampa, FL)
- …of what truly makes us special and impactful. **The Opportunity** As a dedicated Complex Auto Adjuster, you will adjust highly complex auto insurance claims ... and physical damage including total loss settlements for highly complex auto claims. + Negotiates liability for comparative negligence...the auto claims contract as well as application of case law and state laws and regulations. + Demonstrated… more
- Ventura County (Ventura, CA)
- …the Senior Medical Management Nurse is responsible for performing utilization review , case management, and quality improvement functions to ensure that ... a case manager in a health plan case managing complex cases. + Demonstrated experience...+ Principles, practices, techniques and methods used in Utilization review /management, case management, wellness and prevention or… more
- APTIM (Santa Fe, NM)
- **Job Overview:** The Team Lead -- Claims Review is responsible for supervising a multidisciplinary team of claims reviewers, estimators, and support personnel to ... + A minimum of ten (10) years of combined experience in claims/ case processing roles including customer service, data entry, reviewing, and evaluating… more
- ChenMed (Newport News, VA)
- …a high-risk subset of patients after they return to their homes, remote medical record retrieval, review and documentation, post discharge telephone calls, ... care team. This team includes one or more physicians, nurse practitioners, nurse case managers, and social workers dedicated to improving the care of patients… more