- Molina Healthcare (Fort Worth, TX)
- …we are seeking a TX licensed Occupational Therapist to join the utilization management team conducting reviews for cases requiring OT services. Preference will ... you apply to this role. Job Summary Provides support for member services review assessment activities for a specific area of specialty. Responsible for ensuring that… more
- Prime Healthcare (Inglewood, CA)
- …and communicating status of both open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently and ... institution in a Health and Human Services field is highly preferred. 2. Utilization Review /Case Management experience is highly preferred. 3. 1+ year of… more
- Safran (Gainesville, TX)
- …direct management of other employees, primarily it involves the effective independent review of the engineering projects to ensure they are continuing in accordance ... of new product/feature development). B) Act as an independent reviewer of both Master Engineering Reviews and Part Design...any improvements or feedback as needed. C) Ensure all Review Action Item Lists (RAILs) are populated with appropriate… more
- Penn Medicine (Philadelphia, PA)
- …the hospital through teaching, consulting, and advising the care management and utilization review departments and the hospital leadership. The Physician Advisor ... changes in payer rules including CMS rules as it pertains to utilization review * Recommend and request additional and more complete medical record documentation… more
- Prime Healthcare (Evanston, IL)
- …of the various activities of the Case Management Department including utilization management, social services and performance improvement. + Assists with development ... authorizations. + Maintains and coordinates Medi-Cal (TARS) for presentation to on-site reviewer and files them accordingly or as per facility's procedure. + Assists… more
- Boehringer Ingelheim (Ridgefield, CT)
- …execution, and implementation of compelling AI driven content strategies. Through the utilization of AI capabilities, the Sr. AD will identify and implement BI ... auto-tagging, atomic content creation, content hyper-personalization, automated FDA submission, utilization of AI capabilities in NTA processes and content… more
- Penn Medicine (Princeton, NJ)
- …Effective and timely completion of pre-certifications as well as coordination of utilization reviews with utilization management reviewer . Timely and ... accurate completion of UM forms Performance Improvement Participate in hospital and performance improvement initiatives and goals (eg, completion of patient satisfaction surveys, positive patient satisfaction scores, participate in outcome measurements.)… more
- Houston Methodist (Sugar Land, TX)
- …the Senior Denials Management Specialist position is responsible for performing utilization review activities, and monitoring the clinical denial management ... Seven years clinical nursing/patient care experience which includes three years in utilization review , case management or equivalent revenue cycle clinical role… more
- Dartmouth Health (Lebanon, NH)
- …microscopic evaluation of cases. * Experience performing a 10% quality control review of negative Pap tests. * Position requires knowledge of various complex ... and certain conditions apply. Responsibilities * Perform cytologic analyses * Review and assure correct specimen identification and fixation. * Operate cytology… more
- Zurich NA (Schaumburg, IL)
- …medical terminology Preferred Qualifications: + 2 or more years' experience in Utilization Review , Case Management, Workers Compensation, or medical bill reviews ... Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a **Medical Bill Review Senior Nurse** to work from our Schaumburg, IL office.… more