- Cushman & Wakefield (Miami, FL)
- …format for client delivery + Assist the team in performing site assessments to review space efficiencies, utilization metrics and supply and demand studies + ... ways of working + Conducts weekly meetings with direct reports to review open requests/projects **Process Skills** + Strong verbal presentation skills, ability to… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …as appropriate. At the request of the Senior Medical Director of the Physician Review Unit (PRU), the reviewer also provides clinical leadership in other areas of ... to coverage decisions and final determinations regarding coverage in the BCBSMA utilization management system (MHK), so that decisions and medical reasoning related… more
- Actalent (St. Louis, MO)
- Remote Clinical Review Nurse - Prior Authorization Location: Must be located in Central or Eastern time zones Employment Type: Full‑Time About the Role We are ... directors to gather additional information when needed. + Document all review decisions clearly, accurately, and in compliance with regulatory and organizational… more
- Actalent (Baton Rouge, LA)
- …+ Work with healthcare providers and the authorization team to ensure timely review of services and requests, ensuring members receive authorized care. + Coordinate ... guidelines. + Provide education to providers and interdepartmental teams on utilization processes to promote high-quality and cost-effective medical care to members.… more
- Touro University (Hawthorne, NY)
- …opportunities, including emergencies and backfill patients into student provider open slots, review phone call and utilization reports to aid in optimal ... approval of daily codes and notes + Run and review daily student production reports + Meet at least...among them + Increase student productivity by maximizing space utilization + Manage the population of patients assigned to… more
- PCI Pharma Services (Bedford, NH)
- …relationships with all project stakeholders (internal and external) as necessary. + Review and optimize utilization of resources (people, time). + Communicate ... timeline and scope change concerns to Management. Key escalation point for client programs at all stages of execution. + Lead the program and project management team to achieve successful execution of client projects through mentoring coaching and building… more
- Ochsner Health (Slidell, LA)
- …+ Monitor and analyze key performance metrics (eg, report TATs, peer review outcomes, imaging utilization ). + Implement initiatives to reduce unnecessary ... imaging and improve appropriateness criteria compliance. + Partner with hospital quality teams to ensure radiology is an integral part of patient care pathways. **Technology & Innovation** + Stay informed on advancements in imaging technology, AI applications,… more
- Unity House (Troy, NY)
- …integration and promote best practices in recovery-oriented, trauma-informed care. + Review and monitor utilization , documentation, and billing practices for ... compliance and efficiency. + Facilitate staff meetings, trainings, and performance reviews to promote professional development. + Foster a culture of accountability, collaboration, and continuous improvement within the program. + Monitor outcome data and… more
- MyFlorida (Tallahassee, FL)
- OPERATIONS REVIEW SPECIALIST - 60046106 Date: Jan 6, 2026 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 867714 Agency: Children and Families Working Title: OPERATIONS REVIEW SPECIALIST - 60046106 Pay Plan: Career Service Position Number: 60046106… more
- Veterans Affairs, Veterans Health Administration (Birmingham, AL)
- …on current administrative guidelines. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic ... coordinated care delivery model. Coordinates with the patient care team to review clinic appointment availability ( utilization ) to ensure that clinic schedules… more