- University of Utah (Salt Lake City, UT)
- …**Requisition Number** PRN41383B **Job Title** PS Program Assistant **Working Title** Medical Review Coordinator **Job Grade** C **FLSA Code** Nonexempt ... U of U Health - Academics **Department** 00267 - Ophthalmology- Services **Location** Campus **City** Salt Lake City, UT **Type...Work** **that is changing lives** . **About the Role: Medical Review Coordinator** As a Medical… more
- University of Utah (Salt Lake City, UT)
- …**Requisition Number** PRN39526B **Job Title** PS Program Assistant **Working Title** Medical Review Coordinator **Job Grade** C **FLSA Code** Nonexempt ... Posting may close at any time)** **Job Summary** The Medical Review Coordinator ( MRC ) is...with Operational, Executive, and Medical Directors concerning medical histories. + Maintaining excellent customer service … more
- Conduent (Charlotte, NC)
- …and be part of a culture where individuality is noticed and valued every day. ** Medical Review Auditor Analyst (Remote - Charlotte Area)** **Are you a strong, ... please apply!** **Job Summary:** Conduent is seeking an experienced Medical Review Auditor Analyst to join our...medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic… more
- Zurich NA (Schaumburg, IL)
- Medical Bill Review Senior Nurse 123154 Zurich Insurance is currently looking for a ** Medical Bill Review Senior Nurse** to work from our Schaumburg, IL ... quickly and completely, provide status updates to ensure customer satisfaction. + Review assigned medical bills, apply technical insights, applying discretion… more
- Intermountain Health (Las Vegas, NV)
- …and medical review of complex, controversial, or experimental medical services . Engages in peer-to-peer conversations to guide and support delivery ... with MG Clinical Leadership, for the appropriate utilization of medical services within established guidelines and for...in order to be considered for the position.** Performs medical review activities pertaining to utilization … more
- Conduent (Baton Rouge, LA)
- … field?** **Are you eager to learn new skills and help adults in need?** As a Medical Benefit Review Services Associate, Regions 7 and 8, you will ... Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100...medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic… more
- Conduent (Baton Rouge, LA)
- …and be part of a culture where individuality is noticed and valued every day. The Medical Benefit Review Services Associate position presents an exciting ... Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100...medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic… more
- Prime Healthcare (Garden Grove, CA)
- …coding staff, physicians, financial services , onsite and remote utilization review teams with regards to admission criteria, medical necessity, payment ... of the Patient Safety Excellence Award from Healthgrades. Key services include general medical /surgical inpatient care and...a US-based accredited institution in a Health and Human Services field is highly preferred. 2. Utilization Review… more
- The Arora Group (Bethesda, MD)
- …providers in gathering clinical information and may also provide education on the medical review process. + The Contractor performing as the License Practical ... internal and external stakeholders with regard to coverage for services , contract benefits and alternate resources available....services and workforce solutions company that has provided medical care for the men and women who serve… more
- New York State Civil Service (Schenectady, NY)
- …individuals served by the mental hygiene services and children and family services delivery systems.* Attend Medical Review Board meetings as assigned ... the NYS Justice Center for the Protection of People with Special Needs; a medical facility; a child protective services organization; or as a professional… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Utilization Review Services Registered Nurse? At Parallon, you come first. HCA Healthcare has ... colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services ...a difference. We are looking for a dedicated Utilization Review Services Registered Nurse like you to… more
- Houston Methodist (Houston, TX)
- …prospectively or concurrently determines the appropriateness of inpatient or observation services following review of relevant medical documentation, ... (RN) who comprehensively conducts point of entry and concurrent medical record review for medical ...experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare, Medicaid,… more
- US Tech Solutions (Columbia, SC)
- … or behavioral review /authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines. Utilizes ... plans, eligibility, level of benefits , place of service , length of stay, and medical necessity...of stay, and medical necessity regarding requested services and benefit exceptions. Ensures accurate documentation… more
- CommonSpirit Health Mountain Region (Lakewood, CO)
- …in healthcare related field required. License/Certifications Requirement Certified Professional Medical Services Management (CPMSM) or Certified Provider ... to ensure quality patient care by effectively managing the Medical Staff's Peer Review Program, which encompasses...The position is also responsible for the integration of services between the MSSD, IT and Quality Departments with… more
- Adecco US, Inc. (Houston, TX)
- …8am to 5pm **Pay:** $85,00 to $110,000 yearly **Responsibilities of the Utilization Review Nurse:** . ** Review Medical Records:** Thoroughly evaluate patient ... to assess the necessity and appropriateness of treatments and services . . **Conduct Audits:** Regularly audit medical ...disability, additional voluntary benefits , EAP program, commuter benefits and a 401K plan. Our benefit … more
- The Cigna Group (Bloomfield, CT)
- …The Medical Director provides timely expert medical review of medical necessity requests for clinical services that do not meet utilization review ... criteria and renders a clinical opinion about the medical service under review while...timely expert medical review of medical necessity requests for clinical services related… more
- Emanate Health (Covina, CA)
- …care reviews for requested services using clinical judgment and refer to Medical Directors for review depending on case findings. **Job Requirements** **M** ... and the #19 ranked company in the country. **J** **ob Summary** The Utilization Review Nurse will evaluate medical records to determine medical necessity… more
- Bakersfield Behavioral Healthcare Hospital (Bakersfield, CA)
- …teamwork, and communication skills. ESSENTIAL DUTIES The primary responsibility of the Utilization Review Specialist is to review medical records and prepare ... facility situated on 8.8 acres. We offer inpatient and outpatient services for children, adolescents and adults needing mental/behavioral health, chemical… more
- Medical Mutual of Ohio (OH)
- …service provided, length of stay and level of care. + Extrapolates and summarizes medical information for physician review or other external review . + ... Founded in 1934, Medical Mutual is the oldest and one of...ensure the provisions of safe, timely and appropriate healthcare services . Promotes effective use of resources and provides assistance… more
- IQVIA (Durham, NC)
- …maintains an ongoing assessment of the safety profile of the study . Provides medical review of SAE reporting, writes and/or reviews SAE narratives, and works ... issues, as requested . * Data Activities: . Provides medical review of eCRFs for clinical accuracy...IQVIA is a leading global provider of clinical research services , commercial insights and healthcare intelligence to the life… more