Overview: Medical Reviewer III - Managed Care Project (MCP) - REMOTE The Medical Reviewer III (MCP... years’ utilization/quality assurance review and ICD-10-CM/CPT-4 coding experience At least 4 years’ experience in coding...
: 77,105.60 - 119,537.60YEARLY General Summary: The Clinical Reviewer’s chief responsibility is to collect and submit reliable data to the appropriate... or spreadsheet. The Clinical Reviewer works closely with the Performance Improvement Team to identify opportunities for clinical...
expertise strengthening your medical practice with medical necessity and utilization review/management expertise Expanded...Job Description: As Physician Reviewer/Advisor you will utilize clinical expertise and reviews insurance appeals...
JOB TITLE (#24992): Dental Hygienist Reviewer / Contract - Upstate, NY Minimum of 2 years experience in the provision... of clinical services or in quality improvement/utilization reviews Greenlife Healthcare Staffing is currently seeking a Dental...
informed of the latest internal and external issues and trends in utilization and quality management through select committee... What You Will Do Collaborates with clinical management to identify, develop and implement quality improvement standards and criteria that meet...
is responsible for support and assistance for all cardiology administrative and clinical utilization management and quality... has business OTHER SKILLS and ABILITIES: Strong clinical, management, communication, and organizational skills. Demonstrated...
or utilization management experience Insurance Industry experience. Telecommute: This is a Telecommute (Remote) role...-authorization reviews in accordance with the medical contract and regulations, medical criteria, utilization review, and quality...
of Utilization Management (UM), initial and internal appeals decisions. This includes review of clinical information provided... experience in Utilization Management (UM) and/or a Medical Services Organization preferredDemonstrated strong knowledge...
effective utilization of the hospital medical record systems. Responsible for the accurate and timely entry of data into the..., Nursing, Medical Records, and Information Systems Departments whose support is necessary for the management and success of the...
-effective care delivery. Perform pre-certification utilization reviews of Oncology treatment requests Determines medical...-making criteria sets (i.e., Milliman, InterQual) Minimum of one year of experience with medical management activities...
facilities and the provision of management services and evidence-based rehabilitation to the post-release reintegration... of stay; records findings, prepares utilization review reports; conducts evaluation of program activities, to ensure...
facilities and the provision of management services and evidence-based rehabilitation to the post-release reintegration... of stay; records findings, prepares utilization review reports; conducts evaluation of program activities, to ensure...
readmission, identify appropriate inpatient Level of Care, and assist with Independent Peer Review, and Utilization Management.... Utilization management, DRG review, peer review, and claim review experience is desirable. Active, valid, and non-restricted...
, scheduling, supply utilization monitoring etc. E. Leads unit-based peer review processes. Qualifications Education...), e. Actively participates as a peer reviewer for a professional journal (minimum of 2/year, portfolios including “Peer Reviewer...
strengthening your medical practice with medical necessity and utilization review/management expertise Expanded credentials...As Physician Reviewer/Advisor you will utilize clinical expertise and reviews insurance appeals, and prospective...
organization growth and diversification to accomplish entity's vision. A management role that supervises employees focusing... utilization review and analysis. 5. Experience with Electronic Medical Records. Duties and Responsibilities: The duties...
expertise strengthening your medical practice with medical necessity and utilization review/management expertise Expanded...Job Description: As Physician Reviewer/Advisor you will utilize clinical expertise and reviews insurance appeals...
board-certified physician with interest and experience in managed care utilization and case management to support our team... job. Essential Qualifications Board certified MD or DO, with an excellent understanding of the utilization and case management...
, scheduling, supply utilization monitoring etc. E. Leads unit-based peer review processes. Qualifications Education...), e. Actively participates as a peer reviewer for a professional journal (minimum of 2/year, portfolios including “Peer Reviewer...
. Stay for the culture. What You’ll Be Doing: As a FMD, you will be a key member of the utilization management team... in research activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support...