- Excellus BlueCross BlueShield (Buffalo, NY)
- …BH and PH care across the UM/ CM staff. + Participates in clinical peer review recruitment and supervision. + Collaborates with Provider Relations staff to ... program following NYS directives and guidelines. + Completes medical necessity reviews and peer -to- peer calls in timely manner and provides support for the Case… more
- NJM Insurance (Trenton, NJ)
- …and duration are appropriate. + Refer requests that meet established criteria for peer review , fail to demonstrate medical necessity, or present high complexity ... guidelines and documentation used to make determination or to refer for peer physician review are referenced. + Understand, apply, and comply with all statutory,… more
- CVS Health (Tallahassee, FL)
- …the care of patients with severe, complex, and/or treatment resistant illnesses through peer review and educational interventions. * Work with medical director ... regulatory audits in-person. * Support all Clinical Quality initiatives and peer review processes including Quality of Care and Quality of Service (grievance)… more
- Institute of Electrical and Electronics Engineers (Los Alamitos, CA)
- …sessions for requirements, prototypes, and design artifacts. - Conduct code reviews and peer review sessions. Technology Evaluation: - Assist and participate in ... consistently to identify performance issues and resolve them - Conducts code review and peer review sessions Monitoring and maintenance: - Assist in… more
- Veterans Affairs, Veterans Health Administration (Pittsburgh, PA)
- …ultrasound examinations. Participates in Quality Management activities such as film quality review , clerical checks, peer review and other activities ... practices. Participate in various aspects of quality assurance such as peer review , protocol review , appropriateness criteria and performance improvement.… more
- UnityPoint Health (Waterloo, IA)
- …for the oversight of local care delivery including clinical quality, patient safety, peer review and engagement and Medical Staff relationships and governance. ... leadership over the Credentials and Privileges process, direct subsequent review of care including peer review...process, direct subsequent review of care including peer review , direct required regulatory and voluntary… more
- GEHA (Lee's Summit, MO)
- …strict adherence to departmental standards related to documentation and artifacts and provides peer review for the work of other business analysts. **SKILLS** ... clearly defined and provide clear expectations for success. + Comprehensively review and evaluate second level appeals. Determine eligibility, benefits, and prior… more
- Comerica (Farmington Hills, MI)
- …and annual projects (evaluation of goodwill, reviewing new contractual arrangements, peer review analysis, preparation of selected footnote disclosures, ... practical expedients. Position Responsibilities: + Perform technical accounting research, review /prepare documentation supporting accounting conclusions and provide recommendations for… more
- Pacificorp (Portland, OR)
- …for the development and implementation of a robust contract creation process including negotiation, peer review , legal review , business unit review , ... and approval of supply chain staff contracts by administering the peer review process. Create and manage a contract training program including the training… more
- Nuvance Health (Norwalk, CT)
- …action plans to prevent event recurrence and mitigate risk. 9. Collaborates and coordinates with Peer Review partners during the Peer Review Process, ... improvement specialist partners with service line, medical and unit leaders to review and analyze key performance indicators and service line dashboards and to… more
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