- Zelis (NJ)
- …as well as job-related and industry-related knowledge and skills, etc. Base pay is just one part of our Total Rewards package, which may also include discretionary ... bonus plans, commissions, or other incentives depending on the role. Zelis' full-time associates are eligible for a highly competitive benefits package as well, which demonstrates our commitment to our employees' health, well-being, and financial protection.… more
- PNC (Houston, TX)
- …or issues.Participates in continuous monitoring for assigned portfolios. + Oversees file review activities of reviewers as Reviewer in Charge for assigned ... success. We are looking to hire a Credit Risk Review Advisor Senior in Credit Risk Review ...credit exposures. You may have responsibility of being a Reviewer in Charge. The Reviewer in Charge… more
- AmeriHealth Caritas (LA)
- …and providers to collect all information necessary to perform a thorough medical necessity review . It is within the BH UM Reviewer 's discretion to retain ... direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical necessity reviews. Using clinical… more
- TEKsystems (Canoga Park, CA)
- JobTitle: Retro Claims Reviewer Location: West Hills/Canoga Park 91304 Compensation: LVN $38-$40 hourly RN $45-$50 hourly Overview: The Retro Claims Reviewer is ... provider and member claims for accuracy and compliance + Review and process claims in accordance with UM guidelines...+ Ensure HIPAA and PHI compliance throughout all claim review activities + Participate in special projects related to… more
- JPMorgan Chase (Jersey City, NJ)
- …Investment Bank, Wealth Management, and Business Banking lines of business! As a Credit Review Vice President within our Credit Review team, you will take the ... in planning and executing periodic credit reviews, as well as participating in review assignments. Your role will involve guiding team members in activities that… more
- Institute of Electrical and Electronics Engineers (Piscataway, NJ)
- Society Peer Review & Educ Prog Administrator (E5204) - 250321 : KNW-A20 Description Job Summary The overall purpose of this position is twofold: a) Provide support ... to the IEEE Signal Processing Society (SPS) in the receipt, database management, review , and timely publication of journal manuscripts as well as provide first-level… more
- Dignity Health (Chandler, AZ)
- …the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
- Dignity Health (Gilbert, AZ)
- …the Director of Care Management, performs criteria-based concurrent and retrospective utilization review to support and encourage the efficient and effective use of ... Conducts admission and continued stay reviews per the Care Coordination Utilization Review guidelines to ensure that the hospitalization is warranted based on… more
- CaroMont Health (Gastonia, NC)
- …are accurately determined. Refers to physician advisor and /or second level reviewer when necessary. Documents initial review , communications, and referrals in ... Job Summary: Completes initial review for medical necessity for all admissions in...medical necessity will be performed and documented in medical review , including daily status update while patient is in… more
- American Express (New York, NY)
- …launch more than 28,000 marketing campaigns worldwide. The Communications Compliance Review (CCR) team within ECMX is responsible for consulting with marketing ... to develop compliant yet effective marketing and advertising content + Be the final reviewer and approver of American Express advertising before it goes to market +… more