Voca Healthcare is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Elmhurst, New York. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 09/14/2026 Duration...

Uniti Med is seeking a travel Home Health Utilization Review for a travel job in Webster, New York. Job Description & Requirements Specialty: Utilization Review Discipline: Therapy Start Date: 09/14/2026 Duration: 13 weeks 40 hours ...

management, and assistance with the meetings of the Board. Reviews submitted applications, makes the final compliance... with the system set up and revisions of application forms and templates. Conducts reviews of complex scientific research...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on ...

100% Remote Contract Attorney Needed for Growing Labor and Employment Law Firm! This Jobot Consulting Job is hosted by: Bryce Koelsch Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $40 ...

100% Remote Contract Attorney Needed for Growing Labor and Employment Law Firm! This Jobot Consulting Job is hosted by: Bryce Koelsch Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $40 ...

(IPT) and participating in design reviews. Represents the engineering community in the build through post production...

. Primary Responsibilities: Reviews all OASIS assessments to ensure timeliness, appropriateness, completeness and compliance... improvement audits and chart reviews to identify and document required clinical information Provide education and guidance...

according to line of business. Perform peer reviews of prior authorization requests. Maintain or exceed designated quality...

, retrospective review, medical director referrals and execution of member/provider approval and/or denial letter. Reviews provider..., set reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts...

by performing transaction reviews of new and existing clients to evaluate appropriateness of client selection, adherence...

utilization issues; discharge planning reviews and variances of care. Completes all admission, discharge and psychosocial...

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...

Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness...

. How you'll contribute A Utilization Review Specialist who excels in this role: Facilitates clinical reviews for all patient... reviewers, and other payers. Communicates with physicians to schedule peer-to-peer reviews. Accurately reports denials...

(clinical/coding) reviews of medical records and/or other documentation. This role will determine correct DRG/coding as defined... by review methodologies specific to the type of review. This involves completing medical record reviews, accurately documenting...

-in-Charge, executing transaction reviews, secondary reviews of transactional testing completed by others, and issues management... executing transaction reviews, leading examinations as an Examiner-in-Charge (EIC) or Assistant Examiner-in-Charge (AEIC...

and services are medically appropriate Performs prior authorization reviews related to mental health and substance abuse...

and tracking data from various insurance providers and health plans regarding authorization, expedited reviews and appeals...