utilization nurses Follows all departmental policies and workflows in end-to-end management of cases. Participates in team... utilization review activities, including pre-certification, concurrent and retrospective reviews according to guidelines...
: Outpatient Case Management, NaviCare, ACO) and/or other community services according to department protocol Collaborates... with attending physicians and health care professionals regarding appropriate utilization of medical services Completes level...
data mining techniques to identify improvements and address emerging data trends. Oversees the management of reporting... initiatives, programs, and systems that enhance operational efficiency and data utilization. Acts as a mentor and quality...
the daily operations of a department including staff training, development, and performance review, utilization... in field of expertise. Terracon Authorized Project Reviewer status preferred. Exemption Exempt Requisition ID 34465BR...
practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent.... We are searching for providers throughout the state of California. Requirements: As Physician Reviewer/Advisor, you will utilize...
the daily operations of a department including staff training, development, and performance review, utilization... of expertise. Terracon Authorized Project Reviewer status preferred. Exemption Exempt Requisition ID 34463BR Employment...
. Stay for the culture. What You’ll Be Doing: Job Description Cardiovascular Utilization Management Reviewer...? Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... Surgery Spine is required. Requirements: As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the...
practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent.... We are searching for providers throughout the state of Alaska. Requirements: As Physician Reviewer/Advisor, you will utilize...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... Surgery Spine is required. Requirements: As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the...
, this position integrates utilization management with collaborative engagement and innovation. Core Responsibilities Clinical... Review & Peer Collaboration Serve as the physician reviewer for oncology cases that do not initially meet medical necessity...
practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent.... We are searching for providers throughout the state of Oregon. Requirements: As Physician Reviewer/Advisor, you will utilize...
utilization management team. We can offer you a meaningful way to make a difference in patients lives, in a non-clinical... activities/questions related to the Utilization Management process, interpretation, guidelines and/or system support...
the daily operations of a department including staff training, development, and performance review, utilization.... Preferred Certification: Certification or licensure in field of expertise. Terracon Authorized Project Reviewer status...
. Enhanced industry expertise, strengthening your medical practice with medical necessity and utilization review/management... Surgery is required. Requirements: As Physician Reviewer/Advisor supporting Dane Street Legal Services IMEs, the physician...
and/or be a technical reviewer for manufacturing process changes; expertise with management of change (MOC) work process. Engineering... troubleshooting and improve operating discipline. Assist with and/or lead root cause analysis of asset utilization losses in the...
and utilization management reviews for specialty medications, to include site of care assessments, for enrollees of Quantum Health... documentation, and other clinical resources to achieve proper decisions in utilization management reviews. The Pre-Certification...
including utilization management, social services and performance improvement. Assists with development of discharge plans..., TRAINING 1. Knowledge of Discharge Planning/ Utilization Management / Case Management terminology and functions...
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...
coordination of the various activities of the Case Management Department including utilization management, social services... Discharge Plan. Qualifications: EDUCATION, EXPERIENCE, TRAINING 1. Knowledge of Discharge Planning/ Utilization Management...