. More about our team Accountable for the execution, adaptation and outcome of care management as prescribed in the initial Utilization... appropriate level-of-care placement. • Uses EMR and MCG Criteria for utilization management and quality screening. • Identifies...
in Oncology. Requirements: As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals.... Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management...
As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective.... Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management...
in Radiology. Requirements: As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals.... Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management...
Job Description: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical... your medical practice with medical necessity and utilization review/management expertise Expanded credentials as an expert...
. Requirements As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals, and prospective.... Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management...
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... necessity and utilization review/management expertise Expanded credentials as an expert in Independent Medical Exams...
guidance on medical necessity and claims processing. The Physician Reviewer will ensure that all evaluations meet client...-specific policies and are aligned with recognized standards of oncology care. MAJOR DUTIES AND RESPONSIBILITIES: Conduct...
. Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management... processing. The Physician Reviewer will ensure that all evaluations meet client-specific policies and are aligned with recognized...
Job Description: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical... your medical practice with medical necessity and utilization review/management expertise Expanded credentials as an expert...
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... necessity and utilization review/management expertise Expanded credentials as an expert in Independent Medical Exams...
Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise... and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation...
years of previous Nursing work experience. Candidates with previous hospital Case management experience or home care... from physiological and economic perspectives. Has overall accountability for the utilization management and transition management...
Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise... and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation...
license Certification(s): National Certification (i.e. Case Management (CCM), Professional Utilization Reviewer (CPUR... appropriate utilization of care and services, and cost effective outcomes. The Case Manager is responsible for the review of the...
Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise... and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation...
Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise... and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation...
Requirements: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise... and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation...
Requirements As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise... and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation...
/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization... Medical Director in research activities/questions related to the Utilization Management process, interpretation, guidelines...