- Corewell Health (Grand Rapids, MI)
- …in clinical setting + 3 years of relevant experience Managed care experience + LIC- Physician (MD) - STATE_MI State of Michigan or LIC-Osteopathic Physician (DO) ... Michigan Preferred + Proven experience and evidence of success in effective physician communication and education skills + Evaluation of evidence-based standards of… more
- Kelly Services (St. Louis, MO)
- …Government Solutions is seeking Healthcare Providers **(Physicians - MD, DO, Physician Assistants PA, or Nurse Practitioners NP)** to conduct one-time disability ... exams for Veterans. Veterans are in need of assistance for their service-connected disability exams and we are searching for healthcare providers looking to supplement your income while gaining valuable insight into military culture. You will be conducting… more
- Commonwealth Care Alliance (Boston, MA)
- …of community-based assessments for CCA members and ongoing tracking and monitoring. The RN MDS Reviewer is a member of the Minimum Data Set (MDS) Clinical Review ... team of the Care Planning Unit. The RN MDS Reviewer supports successful completion and submission of the MDS...form based on diagnoses / information gathered from record review . + Prepares printed MDS forms for data entry.… more
- AdventHealth (Maitland, FL)
- …and in collaboration with physicians, nursing and HIM coders, the Second Level Reviewer I strategically facilitates and obtains appropriate and quality physician ... complexity of care of the patient. The Second Level Reviewer I educates members of the patient care team...(ROM), and quality._ + _Completes accurate and timely record review to ensure the integrity of documentation compliance._ +… more
- Elevance Health (Los Angeles, CA)
- …determining whether clinical information presented meets medical necessity criteria or requires physician review or override. + Clearly and concisely documenting ... **JR150009 Genetic Counselor Reviewer ** The genetic counselor reviewer (GCR) is...clinical review and other case interactions in online database in adherence… more
- SSM Health (MO)
- …specialized mortality reviews. **Required Qualifications:** + Prior experience as a Second Level Reviewer + Two years in an acute care setting with two years ... to clinical staff regarding these requirements during the concurrent record review process. + Maintains knowledge of mortality models, observed rate/expected rate… more
- University of Miami (Hialeah, FL)
- …staff position using the Career worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The ... Concurrent Quality Reviewer of our hospital reviews documentation in the electronic...Documentation Specialists for concurrent queries to the providers, ensuring physician responses to queries are reflected in the code… more
- Elevance Health (Costa Mesa, CA)
- …expanding set of clinical domains, including radiology, cardiology and oncology._ **Nurse Reviewer I** **Location:** This is a virtual position open to Pacific, ... conducted in CDT, regardless of your individual time zone. The **Nurse Reviewer I** is responsible for conducting preauthorization, out of network and… more
- Elevance Health (San Juan, PR)
- …information technology and business operations services for health plans._ **Nurse Reviewer I** **Location:** This role requires associates to be in-office 1 ... Friday but must be flexible according to business needs. The **Nurse Reviewer I** is responsible for conducting preauthorization, out of network and appropriateness… more
- SSM Health (MO)
- …Performs concurrent analytical reviews of clinical and coding data to improving physician documentation for all conditions and treatments from point of entry to ... the principal diagnosis, pertinent secondary diagnoses, and procedures for accurate diagnosis review group (DRG) assignment, risk of mortality (ROM), and severity of… more
- The Joint Commission (Oakbrook Terrace, IL)
- …and programs that meet DSC certification eligibility criteria. Plans, reviews and apportions review time so that all review requirements are addressed thoroughly ... per program. Reviews and evaluates pre- review information; researches, collects, organizes, and interprets a large volume of information from multiple sources.… more
- Atlantic Health System (Morristown, NJ)
- …with the patients discharge plan. 5. Refers cases and issues to Physician Advisors or Designees in compliance with department procedures with timely follow ... for CMS required patient notices. 8. Completes and documents utilization reviews, physician advisor referrals and other communications related to assigned cases in… more
- The Joint Commission (Oakbrook Terrace, IL)
- …**Responsibilities** **Qualifications** Advanced Degree in Nursing or Licensure as a Physician required. Board Certification is required. You must hold a CPHQ ... of Rehab patients required. Demonstrated experience with Joint Commission Rehab review /survey strongly preferred We are currently hiring intermittent reviewers. All… more
- Prime Healthcare (North Las Vegas, NV)
- …strong relationships and business development activities of the division, including physician and community relations programs. Responsible for achieving goals and ... Performance Reporting and Selling. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/197871/bariatric-clinical- reviewer /job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityNorth Vista Hospital LocationUS-NV-North Las Vegas… more
- MTA (Brooklyn, NY)
- Administrative Physician , Leave and Medical Review Job ID: 11631 Business Unit: MTA Headquarters Location: Brooklyn, NY, United States Regular/Temporary: Regular ... Services Date Posted: Apr 30, 2025 Description JOB TITLE: Administrative Physician , Leave and Medical Review SALARY : $ 190,000 - $ 195,000 DEPT/DIV: HQ/… more
- Logan Health (Kalispell, MT)
- Join Logan Health as an RN Analyst - Physician Peer Review ! Our Mission: Quality, compassionate care for all. Our Vision: Reimagine health care through ... Logan Health has an exciting opportunity for an RN Analyst - Physician Peer Review to join our dedicated team in beautiful Kalispell, Montana! In this… more
- Chenega Corporation (San Antonio, TX)
- …Management + Review trainee case adjudications for quality assurance. + Review a percentage of Independent Case Reviewer (ICR) case adjudications for ... reviews must uphold the requirements for a policy compliant review as per the Independent Case Reviewer ...compliant review as per the Independent Case Reviewer certification requirements of C2 Alaska, LLC. + Consult… more
- Veterans Affairs, Veterans Health Administration (San Antonio, TX)
- …section, service or facility level committees/boards, when assigned. Serve as Peer Reviewer for the Protected Peer Review Committee, when assigned. Demonstrate ... FPPE/OPPE process. Adheres to employee health requirements. Timely participates in peer review process. (4) Time/Leave Management: Adherence to tour of duty and… more
- Sutter Health (Sacramento, CA)
- …Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the hospital's ... care services. The PA will develop expertise on matters regarding physician practice patterns, over- and under-utilization of resources, medical necessity,… more
- Vighter Medical Group (Yuma, AZ)
- Regional Physician Supervisor (RSMD), Local, Yuma, Arizona Job Details Job Location Yuma, AZ - Yuma, AZ Position Type Full Time Education Level Certification Travel ... 25% Job Shift Any Job Category Health Care Description Title:Regional Physician Supervisor (RSMD) Location: Yuma, Arizona Position Type:Full Time (30-40+… more
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