- Public Consulting Group (Council Bluffs, IA)
- …www.publicconsultinggroup.com . **Responsibilities** + Responsible for coordinating program integrity -related reviews with the medical necessity review ... review manager conducting, directing, or leading medical necessity reviews of Medicaid managed care and/or program... necessity reviews of Medicaid managed care and/or program integrity investigations preferred + Previous supervisory… more
- LifePoint Health (Martinsville, VA)
- …evaluate and measure revenue integrity operations; develops systems to manage medical necessity denials; and develops tracking mechanisms to measure loss ... refers to financial counselors for follow up. . Performs medical necessity check, when appropriate (if not...Illness Bank package for full-time employees . Employee Assistance Program - mental, physical, and financial wellness assistance .… more
- Intermountain Health (Broomfield, CO)
- …requirements, as well as Medicare, Medicaid, and Commercial payer coverage and medical necessity criteria. Develop strategy and provide guidance throughout the ... area** **-Certified Revenue Cycle** **Representative(HFMA),** **Certification in Healthcare Revenue Integrity (CHRI) and/or Certified Medical Coder.** **Vitalware,… more
- Waystar (AR)
- …hospital inpatient record types, clinical documentation, payer reimbursement methodology, medical necessity criteria, billing requirements and applicable ... **ABOUT THIS POSITION** We are looking for a Revenue Integrity DRG Auditor who has a comprehensive understanding of hospital Revenue Cycle Management. Significant… more
- Trinity Health (Newtown, PA)
- …areas to effectively document services performed and understand relationship of documentation, medical necessity , coding and charging for all services provided. ... **Description:** Trinity Health Mid-Atlantic is looking for an experienced Revenue Integrity Account Specialist to join our team! Hybrid Schedule: Full-time,… more
- CVS Health (Springfield, IL)
- …of most days completing assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental (Medicare/Medicaid) ... most days completing assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental...Suite Education * Must be graduate of an accredited Medical School and Residency Program * ABMS or… more
- University of Utah (Salt Lake City, UT)
- …and monitoring compliance practices. This incumbent is responsible for conducting medical necessity audits by reviewing clinical practice standards and ... In addition to the clinical expertise needed for the medical necessity reviews, the incumbent will perform...a related field, or the equivalent + Knowledge of medical auditing, Federal healthcare program policies and… more
- Molina Healthcare (Detroit, MI)
- …training, and supervision of the use of the criteria for medical necessity . + Participates in and maintains the integrity of the appeals process, ... + Provides medical oversight and expertise in appropriateness and medical necessity of healthcare services provided to members, targeting improvements… more
- Highmark Health (Charleston, WV)
- …A key component of this role is to review denials of care based on medical necessity . The incumbent acts as a liaison for Highmark Wholecare with ... to provide clinical consultation and support with regard to program development, compliance with accepted medical standards,...Wholecare's core values, Code of Business Conduct and the Integrity Process + Foster a reprisal free environment to… more
- RTX Corporation (Jacksonville, FL)
- …Onsite Collins Aerospace in Jacksonville FL is seeking an experienced Financial Program Cost Schedule & Control Analyst. This Onsite position will be responsible ... for program controls as part of the EPP (Engineered Polymer...decision-making skills + Ability to perform ad-hoc analysis, data integrity checks, and reconciliations + Experience with Microsoft Office… more
- RTX Corporation (East Hartford, CT)
- …our employees to be their whole - best - selves at work because trust, respect, and integrity , are a part of our DNA. At Pratt & Whitney, the difference you make is ... look up. Are you ready to go beyond? Position Overview: Pratt & Whitney's Program Planning & Scheduling (PP&S) organization is searching for a Program Planner.… more
- RTX Corporation (East Hartford, CT)
- …our employees to be their whole - best - selves at work because trust, respect, and integrity , are a part of our DNA. At Pratt & Whitney, the difference you make is ... individual to join its Fighter Mobility team as a Program Analyst on the F119 SPaRE Program .... Contract Data Requirement Lists (CDRLs). + Promote data integrity by properly controlling and monitoring EV systems (wInsight,… more
- RTX Corporation (Windsor Locks, CT)
- …virtual doctor visits . Bright Horizons, child and elder care services . Teladoc Medical Experts, second opinion program . And more! At Collins, the paths ... Aerospace Power and Controls is seeking a dynamic Deputy Program Chief Engineer to lead the coordination of Engine...the industry. Their ideas drive our performance, and their integrity keeps our customers happy. Join us as we… more
- RTX Corporation (Windsor Locks, CT)
- …virtual doctor visits + Bright Horizons, child and elder care services + Teladoc Medical Experts, second opinion program + And more! At Collins, the paths ... Power and Controls organization is looking for a Deputy Program Chief Engineer. In this role, you will help...the industry. Their ideas drive our performance, and their integrity keeps our customers happy. Join us as we… more
- RTX Corporation (Rockford, IL)
- …virtual doctor visits + Bright Horizons, child and elder care services + Teladoc Medical Experts, second opinion program + And more! At Collins, the paths ... Power Systems business in Rockford is looking for a Program Quality Engineer to support the face of Quality...the industry. Their ideas drive our performance, and their integrity keeps our customers happy. Join us as we… more
- RTX Corporation (Haltom City, TX)
- …TX, 76137 USA Position Role Type: Onsite Collins Aerospace is looking for a Program Quality Engineer who will act as the Quality interface including customer and ... supporting DCMA activities both internally and externally at suppliers + Support/Participate in Program Reviews, including but not limited to: PDR, CDR PDPR, MPR +… more
- Nightwing (Sterling, VA)
- … reporting requirements to team members and ensure data collection and data integrity . Create project briefings for Program Manager and Customer review. Document ... intelligence, and services offerings. Nightwing is looking for a responsible program analyst professional to perform a variety of research projects and… more
- RTX Corporation (Tewksbury, MA)
- …a safer, more secure world. Job Summary: Raytheon is seeking an experienced Program Management, Planning & Scheduling professional to join the Program Design ... will be responsible for the development, maintenance and analysis of the Program Master Phasing Schedule and Integrated Master Plan/Integrated Master Schedule -… more
- RTX Corporation (El Segundo, CA)
- …(PACE) (or equivalent) for engineering performance. The PCE ensures the technical integrity of the program and engineering execution across all Integrated ... safer, more secure world. Job Summary: The Next Generation Jammer (NGJ) Midband Program Chief Engineer (PCE) is the program 's primary engineering leadership… more
- Compass Group, North America (Charlotte, NC)
- …to identify opportunities for indexing to the market + Responsible for system data integrity to ensure information accuracy + Execute program strategy to achieve ... Eurest Position Title: MARKETING PROJECT & PROGRAM MANAGER (ONSITE) - CHARLOTTE, NC Pay Grade:...the essential functions of the job based on business necessity . We will consider for employment all qualified applicants,… more