Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational time in our department. Work at the top of ...

Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational time in our department. Work at the top of ...

Description We are hiring for Care Manager RN positions at Providence Alaska Medical Center in Anchorage, AK! Join us as a Care Manager to play a vital, hands‑on role during a transformational time in our department. Work at the top of ...

About Us: 4LEAF, Inc. (4LEAF) is a multi-discipline Firm providing services throughout the United States. For over 20 years, 4LEAF has assisted communities in successfully navigating contract services, leading to fiscally responsible solu...

About Avalon Healthcare Solutions: Avalon Healthcare Solutions is the nation's leader in diagnostic intelligence, uniquely focused on transforming the role of diagnostic testing across the healthcare ecosystem. Our proprietary Diagnostic ...

SSM Health is an Equal Opportunity Employer:Community Description:About SSM Health St. Mary's Hospital - Madison: SSM Health-Dean Medical Group, a 500-physician multi-specialty group, is actively recruiting a Cardiothoracic Surgery Physic...

Multi-Specialty Peer Review Committee Coordinator in San Francisco/Bay Area contract Opportunity! This Jobot Consulting Job is hosted by: Robert Reyes Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resu...

formats currently available. Reviews and evaluates claims made in Voluntary Product Accessibility Templates (VPAT... access and use case information for tech reviewers. Assigns and reviews the work of classified, casual, and student...

advisors within PAS proactively reviews cases concurrently and post-discharge to ensure compliant admission status... analysis of the case and perform case reviews across multiple specialties. Required Qualifications: Active, unrestricted...

The Utilization Review Medical Director is responsible for conducting clinical reviews of Durable Medical Equipment... timely clinical reviews of DMEPOS authorization requests using applicable criteria, including LCDs, Medicaid Manuals...

advisors within PAS proactively reviews cases concurrently and post-discharge to ensure compliant admission status... analysis of the case and perform case reviews across multiple specialties. Required Qualifications: Active, unrestricted...

: Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines... Qualifications Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding...

and/or Medicaid guidelines, send payor specific Notice of Admission and continued stay reviews. “Performs utilization review... managers regarding payor approval/denial of admission and continue stay review. They process payor denials and retro reviews...

Product Teams (IPT) and participates in design reviews. Recommends simple non-destructive test procedures, tools...

. How you'll contribute Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays... and on a timely basis. Interface with managed care organizations, external reviews, and other payers. Communicate with physicians...

, coordination, implementation and outcomes of Plan Medical and Reimbursement Policy, Clinical Coding, Post-service Claims Reviews... operational functions within Post-service Claims Reviews, Clinical Coding, Reimbursement Policy, Departmental Analytics...

of credit portfolios and credit processes. Performs risk based independent reviews of all types of CB loan portfolios...

: Conduct medical records reviews with accurate diagnosis code abstraction in accordance with Official Coding Guidelines... Qualifications Experience with medical documentation audits and medical chart reviews and proficiency with ICD-10-CM coding...

Job Details Job Summary and Responsibilities Conducts admission and continued stay reviews per the Care Coordination Utilization Review... guidelines to ensure that the hospitalization is warranted based on established criteria and critical thinking. Reviews include...

, expedited reviews and appeals. Document and track all communication attempts with insurance providers and health plans and scan...