- CareFirst (Baltimore, MD)
- …Utilizes MCG to act as a resource for the nurses to conduct concurrent review for medical necessity and appropriate level of care for Commercial and Government lines ... of business. Develops and reviews Inpatient Management standards, program criteria, policies, and procedures to ensure quality of care and manage health care costs.… more
- RELX INC (St. Louis, MO)
- …with the internal and external content development partners . + Ensures lead and peer review SMEs are delivering work products per schedule. + Identifies ... About the Role The Digital Content Specialist (DCS) assists the Digital Content Manager with the development and deployment of market - critical, innovative learning… more
- Henry Ford Health System (Jackson, MI)
- …expertise by attending conferences, participating in in services, leadership meetings, huddles, peer review /chart review as appropriate. . Participates in ... all forms of care. Works collaboratively with the Respiratory Therapy Director, Manager and leadership team with regards to development and implementation of… more
- Molina Healthcare (San Bernardino, CA)
- …with utilization/quality program management. * Managed care experience. * Peer review experience. * Certified Professional in Healthcare Management (CPHM), ... services provided to plan members. * Supports plan utilization management program and accompanying action plan(s), which includes strategies to ensure high-quality… more
- Highmark Health (Dover, DE)
- …with all compliance, regulatory and contractual requirements. Conducts ongoing audit review programs, develops tools to assess current outcomes and trends along ... for after-action items as outcome of Quarterly State Audit Reviews, Annual MERCER Review and NCQA Review . Develops ongoing educational programs that ensures… more
- HUB International (Winter Park, FL)
- …and voluntary insurance options + Health Savings Account funding + 401k matching program + Company paid Life and Short-Term Disability Plans + Supplemental Life and ... Long-Term Disability Options + Comprehensive Wellness Program + Paid Parental Leave + Generous PTO Package...Collaborate with the South Compliance team to create, coordinate, review , monitor and evaluate educational material or training sessions… more
- Entergy (Little Rock, AR)
- …Entergy Services, LLC **Job Purpose** Reporting to the Service Delivery Manager (SDM) within Information Technology (IT) Infrastructure Hosting, Intern will serve ... development and implementation of approved CI or automation tasks. Review and update existing automation to remain compliant and...under the guidance of team leads and collaborate with peer team members, to perform tasks and complete goals… more
- PNC (Pittsburgh, PA)
- …etc.) 17. Formulate, document and defend new technology strategies 18. Perform peer review of other designs Qualifications * Education & Experience: ... on a weekly basis. Some responsibilities may be performed remotely, at the manager 's discretion. PNC will not provide sponsorship for employment visas or participate… more
- Citigroup (New York, NY)
- …to include in products. + Build and maintain partnerships across Citi and with peer intelligence organizations. + Review threats that create risk to the company, ... day-to-day operations of the Intelligence Stakeholder Engagement and Strategic Planning program . The analyst will conduct strategic and operational analysis of… more
- Mount Sinai Health System (New York, NY)
- …peers to determine quality and appropriateness of care provided; + Engage in ongoing peer review and quality improvement activities; + Monitor the quality of ... Attending Physician Grade: Faculty Reports to: School Based Health Center Program Medical Director, Mount Sinai Adolescent Health Center **Primary Purpose:** The… more
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