- County of Los Angeles, CA (Los Angeles, CA)
- …REQUIREMENTS: OPTION I: One year of experience performing the duties of a Utilization Review Nurse * or Medical Service Coordinator, CCS.** -OR- OPTION II: ... regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our team....needed, and to make recommendations on potential areas for medical care evaluation studies. Attends Utilization Review … more
- Chubb (Walnut Creek, CA)
- …to case closure ensuring strong customer relations are maintained throughout the process. Review and assess new medical -only claims to determine eligibility ... Job Description Chubb is currently seeking a Workers' Compensation Medical Only Claim Examiner for our West Coast/Pacific region. The successful applicant will… more
- Allegheny County (Pittsburgh, PA)
- …nursing, or employed by the Allegheny County Health Department as a Public Health Nurse . AND License Requirement Possession of a license as a registered nurse ... as issued by the Pennsylvania State Board of Nurse Examiners and in good standing. In addition, must...a copy of your official college transcripts for your claim to be accepted. Unofficial Transcripts will not be… more
- Constructive Partnerships Unlimited (New York, NY)
- …Interdisciplinary Treatment Team to ensure that all team members are aware of all medical conditions and care. 8. Review reports daily to ensure timely, ... and regulatory standards. 6. Participate with nursing management to review , update and develop policies and procedures for clinical...investigations and reviews. SUPERVISES : Nurse Educators Nurse Case Managers (NCM) Medical Case Manager… more
- Pivot OnSite Innovations (Fall River, MA)
- …are the foundation for our unique culture. Job Summary: The Licensed Practical Nurse (LPN) coordinates health care for employees in the onsite clinic, overseeing ... evaluation and case management of workplace injuries as well as compliance with medical surveillance programs. The LPN relays information to employees and client key… more
- US Tech Solutions (Columbia, SC)
- …Utilizes available resources to promote quality, cost effective outcomes. Performs medical or behavioral review /authorization process. Ensures coverage for ... over phone. Strong reading comprehension as they will read and interpret medical policies. Responsibilities: Reviews and evaluates medical or behavioral… more
- Blue Cross and Blue Shield of Minnesota (St. Paul, MN)
- …procedures to determine clinical appropriateness. Completes review of both medical documentation and claims data to assure appropriate resource utilization, ... You Will Have This job implements effective utilization management strategies including: review of appropriateness of pre and post service health care services,… more
- UnitedHealth Group (Los Angeles, CA)
- …letters, engagement in peer-to-peer conversations) Close collaboration with a team of medical directors, nurse coders, and operations team to deliver DRG ... Excellence, a national OptumCare team, is currently seeking an experienced National Medical Director to join our growing Value Innovations efforts. This key… more
- St. Luke's University Health Network (Allentown, PA)
- …health care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure ... medical care for appropriate reimbursement. Work with the physician advisor in review of patient medical records identified by RAC/MIC/QIO and other… more
- VA Boston Healthcare System (Boston, MA)
- …are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply. Duties ... are seeking an enthusiastic internist with a passion for medical education for a full time position as ...care are encouraged. Each physician is assigned a registered nurse , clinical associate, and scheduler. There is no call,… more
- Gallagher (Baton Rouge, LA)
- …case management through telephonic and in-person contact with injured workers and medical providers. Coordinates with employers and claims professionals to ... up to 2 hours. How you'll make an impact Key Responsibilities: Coordinating medical evaluation and treatment Meeting with physician and injured worker to collaborate… more
- CAMC Health System (Charleston, WV)
- …by policy, and disposition of calls. Retrieve, photocopy, as necessary and file medical records; prepare, review and process records to ensure completeness and ... rendering services to the patient, as directed by the provider or Registered Nurse if applicable as outlined in departmental policies and procedures. Duties may… more
- Lee County, FL (Fort Myers, FL)
- …for administering the Lee County Land Development Code and coordinating the review and analysis of applications for development orders, limited development orders, ... county staff with a wide range of expertise to review , analyze, and make recommendations relative to land use...family members of such service members and veterans, who claim and meet eligibility requirements of veterans preference, receive… more
- Kaiser Permanente (Downey, CA)
- …corrective action plan for areas of improvement identified through utilization review , clinical records audit, claim denials, member satisfaction surveys, ... improvement evaluations, special projects, and other work for multidisciplinary review ; investigating opportunities to improve the reporting and narrative summaries… more
- Plastic Surgical (Garden City, NY)
- …to laser treatments and skin tightening, our highly skilled physician assistants, nurse practitioners, and medical aestheticians offer services customized to ... Plastic Surgical Group: Annual bonuses based on performance evaluation. Medical , Dental, & Vision Benefits 19 PTO days, and...all aspects of the account follow up on insurance claims to ensure timely collection Prepare delinquent accounts for… more
- The Overlook (Charlton, MA)
- …nursing practice. Assures medical record claims integrity and clinical claims oversight. Performs duties of a registered nurse . Other responsibilities as ... variety of means such as home visits, conferences, record review , etc. Provides feedback to Team Members to enhance...in Nursing - required *Master's Degree - preferred *Registered Nurse with current licensure to practice professional nursing in… more
- Herc Rentals (Bonita Springs, FL)
- …accounts sent by collections and field staff to ensure credit is secured Review of compliance standards as requested for internal and external audit Responsible for ... and statistics, including improvements to relating databases, to upper management Review of external sourcing for collection agencies and attorney-placed accounts… more
- County of Los Angeles, CA (Los Angeles, CA)
- …acceptable standards of care and establishes and modifies program monitoring and review methods as necessary. Oversees audits and the implementation of audit ... as a clinical social worker, marriage and family therapist, psychologist, or registered nurse issued by the appropriate State of California licensing agency - AND -… more
- UNC HEALTH (Chapel Hill, NC)
- …collaboration with the NC Jaycee Burn center medical director monthly to review and close workers' compensation claims for injured workers admitted into the ... with minimal supervision. Responsibilities: 1. Barrier removal-Works with employer, nurse case manager, attorney, insurance adjustor, injured employee and others… more
- Stormont Vail Health (Topeka, KS)
- …per week: 36 Job Information Exemption Status: Non-Exempt A Brief Overview Medical /Surgical nursing is a specialty within the nursing profession that encompasses the ... life span who present with physical, emotional, or psychological alterations of health. Medical /Surgical nursing is care of acute and chronic illnesses in nature and… more
