- Lilly (Indianapolis, IN)
- …make life better for people around the world. **Purpose:** The Case Management Medical Review Scientist is responsible for conducting comprehensive medical ... and any related duties that might be required for the role/position. Medical review of ICSRs + Conduct comprehensive ICSR medical reviews across… more
- CVS Health (Columbus, OH)
- … medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Medical Review , you'll play a vital role in ensuring members receive ... skills in a collaborative process to implement, coordinate, monitor and evaluate medical review cases. + Applies the appropriate clinical criteria/guideline and… more
- Takeda Pharmaceuticals (Lexington, MA)
- …Drive innovation by integrating AI technologies to streamline medical information review processes, optimize medical review workflows, and leverage ... Information and Review subject matter expert representative at US Medical Unit meetings. * Medical review of other materials pertinent to Takeda business… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 127127 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse** to work from our Schaumburg, IL ... quickly and completely, provide status updates to ensure customer satisfaction. + Review assigned medical bills, apply technical insights, applying discretion… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- …Utilization Management services to its clients. The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with ... and changing environment- flexibility in assignment. * Proficient in Utilization Review process including benefit interpretation, contract language, medical and… more
- Robert Half Accountemps (Los Angeles, CA)
- …records teams to resolve discrepancies. Requirements + Previous experience in EOB review , medical billing, or healthcare claims processing preferred. + ... Description A Hospital in Los Angeles is seeking a detail-oriented EOB Review Specialist to join the healthcare billing team. The EOB Review Specialist is… more
- Gilead Sciences, Inc. (Foster City, CA)
- …company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. We strive to transform and simplify care for people with ... centric, science focused company. Reporting to the Executive Director of Global Medical Affairs Technology, this individual will be responsible for driving delivery… more
- Prime Healthcare (Inglewood, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/231150/ medical - review -coordinator/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... Overview At Centinela Hospital Medical Center, our dedicated team of professionals are...open and closed accounts for multiple levels of Utilization Review and Case Management reporting. Able to work independently… more
- Prime Healthcare (Ontario, CA)
- …Connect With Us! (https://careers-primehealthcare.icims.com/jobs/232555/ medical - review -coordinator/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) ... members to join our corporate team! Responsibilities Coordinates and reviews all medical records, as assigned to caseload. Actively participates in Case Management… more
- CaroMont Health (Gastonia, NC)
- …daily reviews of medical necessity will be performed and documented in medical review , including daily status update while patient is in observation status. ... Job Summary: Completes initial review for medical necessity for all admissions in assigned area(s), applying established criteria within 24 hours of admission.… more
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