- Rush University Medical Center (Chicago, IL)
- …Applies criteria, performs concurrent review process. Works with physicians and Medical Director regarding Case issues and concurrent denials as indicated. ... **Job Description** Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical ...Offers may vary depending on the circumstances of each case . **Summary:** The Social Work Care Mgr (CM) works… more
- Elevance Health (Indianapolis, IN)
- …be an Indiana resident ** The ** Medical Management Nurse** is responsible for review of the most complex or challenging cases that require nursing judgment, ... care, eg, if services are not in line with diagnosis. + Provide consultation to Medical Director on particularly peculiar or complex cases as the nurse deems… more
- BeOne Medicines (San Mateo, CA)
- …data & drafts response and manages approval of responses + Guides and leads medical review of SAEs and provides immediate input to escalated reports, determines ... product program wide input to CRFs + Leads the formulation safety criteria and review of study specific medical monitoring plans + Participates in investigator… more
- Datavant (Pierre, SD)
- …rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, ... attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a...facility. + Experience with significant level of coding quality review feedback + Experience in computerized encoding and abstracting… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- … review activities pertaining to utilization review , quality assurance, and medical review of complex , controversial, or experimental medical ... general psychiatry and/or addiction disorders. + Ability to identify, analyze and resolve complex medical issues. + Skills in evidence-based medicine. + Strong… more
- Datavant (Park Rapids, MN)
- …rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, ... Location: Park Rapids, MN + Full time benefits including medical , dental, vision, 401K, tuition reimbursement + Paid time...reviewed by Datavant Human Resources and determined on a case -by- case basis. Depending on the state in… more
- Gilead Sciences, Inc. (Foster City, CA)
- …product lifecycle in compliance with relevant regulations, standards, and guidelines for medical devices, combination products and diagnostics. + Review device ... for case processing and safety reporting. + Contribute to medical device / combination product Post-Market Surveillance (PMS), including planning and report… more
- Elevance Health (Ashburn, VA)
- …and/or medical policies. May collaborate with healthcare providers. Focuses on relatively complex case types that require the training and skill of a ... and ensures essential face-to-face onboarding and skill development._ The ** Medical Management Clinician Sr** is responsible for ensuring appropriate, consistent… more
- Datavant (Bridgeport, CT)
- …rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, ... or responsibilities as evident or required. + Consistent application of medical privacy regulations to guard against unauthorized disclosure. + Responsible for… more
- CGI Technologies and Solutions, Inc. (St. Louis, MO)
- …and deploying modernized eCommerce solutions. You will be involved in complex projects working with smart, dedicated people, building forward-looking solutions and ... successful integration of all interfacing components. * Develop and modernize complex applications. * Lead the full software lifecycle development process, from… more