- Mount Sinai Health System (New York, NY)
- …Description** **Director Medical Affairs Operations-Medical Staff Services -Full-Time -Days ( Remote )** _Our flexible remote opportunities offer an excellent ... opportunity for those who flourish in a remote environment to achieve improved work/life balance as well...all matters related to medical staff governance, credentialing, peer review and performance management; + In collaboration with the… more
- Bowman (Westminster, CO)
- …and within company policies and procedures. + Provide work assignments and review performance to ensure the efficient, cost-effective utilization of staff. ... Team Lead to join our team in Bentonville, AR ( Remote ). At Bowman, we believe in creating opportunities for...execution. Manage people and processes to ensure effective execution. Review work produced by staff for quality assurance. +… more
- Optiv (Overland Park, KS)
- …right staff assignments are made in right timeframes. + Maximize utilization . + Increase visibility of availability. + Assess skills/certifications against pipeline, ... the identification and assignment of services team members and subcontractors. + Review schedule data proactively to maintain high degree of timelines, accuracy, and… more
- Cordis (Miami Lakes, FL)
- …EMEA, and APAC) focusing on understanding, optimizing, and directing IT spend and asset utilization . This is a remote role within the continental US and will ... impact IT spend. + Conducting various forms of Cordis IT spend and utilization analysis supported by market data, internal and external benchmarks, and current… more
- NexTec Group (TX)
- …must be located in the United States or Canada. This is a remote role. Objectives (Key Outcomes): + Complete assigned tasks independently and may collaborate ... within alignment of the Statement of Work, Business Process Review (BPR) documentation, and NexTec methodology. + Maintain at...and NexTec methodology. + Maintain at least 75 percent utilization on an average annual basis. + Maintain Acumatica… more
- Highmark Health (Harrisburg, PA)
- …**Job Description :** **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member panel. Provides ... to appropriate resources for additional support. + Implement care management review processes that are consistent with established industry, corporate, state, and… more
- Insight Global (New York, NY)
- …preferred - 5-6+ years of clinical practice can be flexible - 1+ years of utilization review experience in a managed care plan (health care industry) - Licensed ... Job Description Insight Global is hiring a fully remote Physician Reviewers for a leading health insurance...a leading health insurance company. The Physician Reviewer will review requests for care before, during, and after treatment… more
- Actalent (Des Moines, IA)
- …and familiarity with HEDIS measure specifications. * Prior work in utilization management, quality management/ review , accreditation, outpatient clinic setting or ... Remote HEDIS Nurse Consultant Description HEDIS work typically...provider, and their office staff, regarding the HEDIS initiative Review and abstract 40-50 medical records per day, based… more
- Providence (CA)
- …in a medical record. + 2 years - HEDIS, Quality management/quality improvement/ utilization review auditing experience, including experience in auditing within ... and Data Information Set (HEDIS) program + Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records… more
- CenterWell (Salt Lake City, UT)
- …practices. + Improving performance of practices. + Evaluate practice workflow + Review and analyze data and make recommendations + Responsible for performance ... Payor Org. + Experience in Medicare Risk Adjustment, Cost Management, Utilization Management. + Advanced organizational skills and/or project management + Ability… more