- CHRISTUS Health (Alamogordo, NM)
- …and assists him/her in ensuring proper placement of patient. Conducts utilization review using nationally recognized medical necessity criteria and documents the ... review . Refers cases for second level reviews when medical necessity criteria are not met. Demonstrates familiarity with the various levels of care and community… more
- General Dynamics Information Technology (Fairfax, VA)
- …QC of case received documents, attachments and materials. + Performing pre- reviewer duties to include QC of leads scheduled, assigned and accepted by field ... Required:** None **Job Family:** Quality Assurance **Skills:** Coverage Analysis,Documentation Review ,Editing,Microsoft Office,Microsoft Outlook **Experience:** 1 + years of related… more
- General Dynamics Information Technology (Fairfax, VA)
- …today is safe and tomorrow is smarter. Our work depends on a motivated BI Case Reviewer - casual joining our Personnel Vetting and Security team to support ... located in Chantilly, VA. At GDIT, people are our differentiator. As a BI Case Reviewer - casual you will support a large national background investigations… more
- City of New York (New York, NY)
- …The Office of Constituent Services (OCS) is seeking (1) Eligibility Specialist II to function as Case Reviewer . The Case Reviewer will: - Respond to ... (NAMI-Net Available Monthly Income) if institutionalized. - Interview and/or review documentation submitted by applicants/recipients (A/R) or authorized representatives,… more
- City of New York (New York, NY)
- …for (1) one Principal Administrative Associate II to function as a Quality Control Case Reviewer , who will: - Conduct the preliminary monthly review ... the review sample by conducting preliminary WMS inquiries and case review ; utilize reports to verify that sample is auditable; identifies inconsistencies,… more
- City of New York (New York, NY)
- …the final report. CA PERT Sr. Reviewer prepares lawsuit packets for each case in the review for electronic transmission to NYC Corporation Counsel. - Conduct ... during customer interaction, and determine whether appropriate action was taken. - Review case file information, POS entries and WMS data to report on the… more
- CACI International (Wooster, OH)
- DHS Experienced Case Reviewer Job Category: Investigation Time Type: Part time Minimum Clearance Required to Start: Top Secret Employee Type: Part-Time On-Call ... employees and contractors for security clearances. **POSITION** **SUMMARY:** The Reviewer scrutinizes reports of investigations submitted by Contract Field… more
- CACI International (VA)
- Case Reviewer (Experienced) Job Category: Investigation Time Type: Full time Minimum Clearance Required to Start: Top Secret Employee Type: Regular Percentage of ... some of the nation's most sensitive missions. **POSITION SUMMARY:** The Reviewer scrutinizes reports of investigations submitted by Field Investigators and Record… more
- City of New York (New York, NY)
- …Office of Constituent Services (OCS) is seeking (2) Eligibility Specialist II's to function as Case Reviewers. The Case Reviewer will: - Respond to inbound ... (NAMI-Net Available Monthly Income) if institutionalized. - Interview and/or review documentation submitted by applicants/recipients (A/R) or authorized representatives,… more
- City of New York (New York, NY)
- …is recruiting for (1) one Supervisor of Nurses to function as a Complex Medical Case Reviewer , who will: - Conduct medical reviews and analyses claims to ... calculate injury related Medicaid liens pursuant to SSL-104b on cases involving Medical malpractice, mass medical torts, lead paint poisoning, traumatic brain injury, or other catastrophic or medically complex cases. - Consult Medicaid payment records, bills… more
- City of New York (New York, NY)
- …information to ensure that data collected is complete, accurate and appropriate to the case under review . - Prepare manual budgets to replicate the actual ... Administrative Associate II to function as a Quality Control Case Reviewers, who will: - Be responsible for the...information in order to determine if discrepancies exist. - Review POS, HRA One Viewer of imaged/scanned documents, Welfare… more
- City of New York (New York, NY)
- …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... for (2) two Principal Administrative Associates IIIs, who will function as Senior Case Reviewers: - Conduct legally mandated case reviews to comply with… more
- City of New York (New York, NY)
- …medical and mental health policies, programs, and initiatives that support best case practice agency wide. The Medical Review Authorization and Monitoring ... the health care provided is comprehensive and appropriate. OCFH also offers individualized case consultations and training to ACS staff and foster care agencies on a… more
- Treasury, Departmental Offices (Washington, DC)
- …of Foreign Assets Control. As a Government Information Specialist (Senior FOIA Reviewer ), you will be conducting quality assurance reviews of all of OFAC's ... and how to apply. Responsibilities As a Government Information Specialist (Senior FOIA Reviewer ), you will: Serve as the Senior FOIA Reviewer conducting quality… more
- Public Consulting Group (Columbus, OH)
- …reflection of our clients and the people they serve. **Responsibilities** **Onsite Reviewer (OH Department of Medicaid) in Ohio** **(Location - Cleveland/ Akron/ ... Canton/Youngstown/Columbus area)** **Onsite Reviewer Job Description:** The overarching responsibility for this position...by the Ohio Department of Medicaid (ODM). The Onsite Reviewer will operate on a solo basis, within a… more
- Adams County Government (Westminster, CO)
- …of casework practice through collaboration with managers, supervisors, and caseworkers. Develops case review tools for various child welfare practice topics. ... Casework Quality Reviewer Print (https://www.governmentjobs.com/careers/adams/jobs/newprint/4526045) Apply Casework Quality Reviewer Salary $63,436.17 -… more
- Independent Health (Buffalo, NY)
- …benefits and commitment to diversity and inclusion. **Overview** The Contractual Reviewer -Senior will be responsible for providing an organized, timely and ... consistent review and investigation of provider and/or member complaints and/or...of provider and/or member complaints and/or appeals. The Contractual Reviewer -Senior will be required to rely on their ability… more
- HCA Healthcare (Corpus Christi, TX)
- …Christi Medical Center Bay Area! **Job Summary and Qualifications** The Review Nurse Clinical Reviewer position encompasses multiple responsibilities including ... about delivering patient-centered care?** Submit your application for Registered Nurse Clinical Reviewer position and spend more time at the bedside with the… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, April 29, 2024 Centers Plan for Healthy Living's goal is to ... need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial Adverse Determinations or… more
- University of Miami (Hialeah, FL)
- …. The Clinical Documentation Integrity (CDI) Second Level Reviewer performs high-level, complex, secondary case reviews ... care. Serves as key resource for CDI/Coding/Quality. The CDI Second Level Reviewer works in collaboration with CDI & quality leadership, CDI specialists, coders,… more
