- CVS Health (Columbus, OH)
- …it all with heart, each and every day. **Position Summary** The Care Plan Reviewer (Clinical Case Manager BH) utilizes advanced clinical judgment and critical ... Members: + Through the use of clinical tools and information/data review , conducts comprehensive assessments of referred member's needs/eligibility and determines… more
- State of Colorado (Colorado Springs, CO)
- CDOC - Program Management I (Use of Force Reviewer ) Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/5056854) Apply CDOC - Program Management I ... (Use of Force Reviewer ) Salary $7,610.00 - $12,177.00 Monthly Location Colorado Springs,...are not limited to: + The second level of review on all use of force incidents: Shift Commander… more
- Magellan Health Services (Honolulu, HI)
- …solutions that directly influence quality of care. General Job Information Title HMSA Care Manager - BH, UM Reviewer - Remote Hawaii Grade 24 Work Experience ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes alternative… more
- AdventHealth (Orlando, FL)
- …and in some situations the supervision of the Clinical Documentation Integrity Manager , and in collaboration with physicians, nursing and HIM coders, the Second ... Level Reviewer I strategically facilitates and obtains appropriate and quality...(ROM), and quality. + Completes accurate and timely record review to ensure the integrity of documentation compliance. +… more
- Commonwealth Care Alliance (Boston, MA)
- …* The Utilization Management Reviewer reports to the Utilization Management Manager . * Conducts timely clinical decision review for services requiring prior ... under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization … more
- Jabil (Hunt Valley, MD)
- …vibrant and diverse communities around the globe. Job Summary: The Quality Control Data Reviewer I is responsible for the accurate and timely review of ... in support of pharmaceutical product development and manufacturing. The Data Reviewer I will verify compliance with Good Manufacturing Practices (cGMP), Good… more
- Citizens (Johnston, RI)
- Description The Real Estate & Insurance Risk Reviewer will be the primary reviewer and point of contact with RMs/PMs in the completion of property insurance ... interaction with RM/PMs and CLO as Subject Matter Expert in assisting them review a borrower's property insurance package both on annual renewals and a transactional… more
- St. Luke's University Health Network (Bethlehem, PA)
- …regardless of a patient's ability to pay for health care. The Admission's Clinical Reviewer is responsible for the comprehensive medical review and screening of ... and responds to all inquiries for admission to ARC + Completes thorough review of documentation and information and assesses a patient's appropriateness for ARC… more
- American Red Cross (NC)
- …Summary:** The Hurricane Helene Expanded Recovery Assistance (ERA) Casework Document Reviewer reports to the Hurricane Helene Individual Resiliency and Preparedness ... Manager and plays a critical role in evaluating and...in the aftermath of Hurricane Helene. The Casework Document Reviewer will coordinate closely with the Hurricane Helene Long-Term… more
- Elevance Health (San Juan, PR)
- …information technology and business operations services for health plans._ **Nurse Reviewer I** **Location:** This role requires associates to be in-office 1 ... Friday but must be flexible according to business needs. The **Nurse Reviewer I** is responsible for conducting preauthorization, out of network and appropriateness… more