Job Summary: Responsible for carrying out medical necessity reviews on all designated referrals for Home Care, DME... established criteria and guidelines for coordination of services. Eligibility and benefit reviews will be performed as necessary...
Kaiser Permanente ⚡⚡ Fri, 13 Mar 2026 07:00:47 GMT
/Management Nurse is also responsible in performing and completing medical necessity reviews utilizing McG and Interqual Review... Guidelines ensuring adherence to said guidelines for admission and continued stay reviews. The Utilization Review/Management...
NOR Healthcare Systems ⚡ $56 - 77 per hour ⚡ Thu, 12 Mar 2026 23:40:30 GMT
workers compensation laws and defenses Within the scope of authority, reviews and authorizes worker’s compensation settlement... and accurate Reviews costs associated with all claims handling and develops strategies to improve performance Works with TPA...
Aerotek ⚡ $60000 - 80000 per year ⚡ Thu, 12 Mar 2026 03:51:50 GMT
& Investment Banking and Credit Risk Review experience. The candidate will conduct independent credit reviews to ensure compliance... Monitoring reviews on assigned portfolio segments to enhance the early detection of credit risk and enhance CRR’s Risk Assessment...
BBVA ⚡ $150000 - 170000 per year ⚡ Wed, 11 Mar 2026 02:38:41 GMT
of identified patients to identify quality, timeliness and appropriateness of patient care. Conducts admission reviews for Medicare... review activities with payers on a daily basis. Performs concurrent and retrospective clinical reviews with various payers...
effectiveness of loan administration functions. Assists with the effective communication of results from reviews, in verbal.... Evaluates adequacy of loan and collateral documentation and the effectiveness of loan administration. Reviews commercial...
Premier Bank ⚡ $50000 - 54000 per year ⚡ Fri, 06 Mar 2026 06:27:25 GMT
-based care for members. This role applies professional nursing judgment to conduct prior authorization reviews, facilitate... and benefit coverage. Conduct prior authorization and HRS flex reviews, applying nursing judgment to ensure timely, cost...
effectiveness of loan administration functions. Assists with the effective communication of results from reviews, in verbal.... Evaluates adequacy of loan and collateral documentation and the effectiveness of loan administration. Reviews commercial...
and nursing facilities in Washington, DC and Maryland to complete utilization and quality reviews Candidates must reside... quality improvement and utilization management reviews to assess residents continued need for services and level of care...
Job Description: MUST ALREADY HAVE EXPERIENCE DOING BILL AUDIT REVIEWS FOR DIFFERENT STATES. We are seeking... an experienced CPC-certified medical coder with multi-state experience to perform coding audits, utilization reviews, demand package...
review of data to determine eligibility respective to pre-certification and continued stay reviews. Job Duties... and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment...
Universal Health Services ⚡⚡ Thu, 05 Mar 2026 05:39:30 GMT
review of data to determine eligibility respective to pre-certification and continued stay reviews. Job Duties... and continued stay reviews into Midas, follow-up on unfinished pre-certifications from the day before, coordinate with the treatment...
TMC Bonham Hospital ⚡⚡ Thu, 05 Mar 2026 04:39:10 GMT
RN, Specialty Care Review
Job Summary: Responsible for carrying out medical necessity reviews on all designated referrals for Home Care, DME... established criteria and guidelines for coordination of services. Eligibility and benefit reviews will be performed as necessary...
Kaiser Permanente ⚡ ⚡ Fri, 13 Mar 2026 07:00:47 GMT