- Centene Corporation (Sacramento, CA)
- …of all appeals requests + Partners with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry ... anywhere within the state of California. **Position Purpose:** Performs clinical reviews needed to resolve and process appeals...analyzing the basis for the appeal + Ensures timely review , processing, and response to appeal in accordance with… more
- State of Colorado (CO)
- CDOC Mental Health Clinician (Social Worker/Counselor III) - Statewide Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4345367) Apply CDOC ... Mental Health Clinician (Social Worker/Counselor III) - Statewide Salary $6,750.00 -...Colorado Department of Corrections Mission: $25,000 HIRING INCENTIVE FOR CLINICAL PROFESSIONALS! If your goal is to build a… more
- City and County of San Francisco (San Francisco, CA)
- …and + May perform Quality Improvement activities such as chart audit and compliance review . + The 2932 Senior Behavioral Health Clinician performs related duties ... Francisco continuously accepts applications for all permanent Senior Behavioral Health Clinician 2932 positions. Rather than publishing separate job ads for every… more
- City and County of San Francisco (San Francisco, CA)
- …of San Francisco continuously accepts applications for all permanent Behavioral Health Clinician 2930 positions. Rather than publishing separate job ads for every ... Housing and the Department of Public Health can then review your application and contact you directly with details...from them Under general supervision, the 2930 Behavioral Health Clinician performs essential duties that include, but are not… more
- State of Colorado (Denver, CO)
- Mental Health Clinician I - Forensics/Civil- Colorado Mental Health Hospital in Fort Logan Print ... (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4547832) Apply Mental Health Clinician I - Forensics/Civil- Colorado Mental Health Hospital in Fort… more
- Hartford HealthCare (Mansfield Center, CT)
- …HealthCare at Home is looking for a Quality Safety Clinician to manage the review of clinical documentation and assists in the training of clinical staff ... outcome studies * results, and internal and external record review * Collaborates with clinical supervisors and...claim audits, and assists with record reviews, audits and appeals as needed. * Participates in quality assurance audits,… more
- Spokane County (Spokane, WA)
- … clinical quality, Encounter Data Validation (EDV), including documentation, utilization review , internal and external clinical record reviews and outcomes. + ... position maintains and continuously improves the quality of operations; clinical services delivery, program administration and oversight, adherence to compliance… more
- Elevance Health (Manchester, NH)
- …case reviews with attending physicians or other ordering providers to discuss review determinations. + Interprets existing policies or clinical guidelines and ... an extraordinary impact.** Responsible for serving as the lead clinician for a plan. Responsible for the administration of...or territory of the United States when conducting utilization review or an appeals consideration and cannot… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …obtains necessary authorizations for release of PHI, prints record for QM clinical review . Works collaboratively with Accounts Receivable to prepare invoices ... Reviews forms for proper completion and provides feedback to clinician regarding errors or omissions. + Conducts compliance related...lawsuits. + Utilization Review : Identifies charts for review under guidance of QM Clinical Analyst.… more
- Thomas Edison State University (Trenton, NJ)
- …components to maintain regulatory and accreditation compliance. -Assist with the review and selection of program candidates. -Monitor formative and summative program ... evaluation metrics. - Review and recommends revision of program curriculum. -Meet/exceed expected program outcomes and benchmarks. -Develop action plans if standards,… more