Slate Healthcare is seeking a travel nurse RN Utilization Review for a travel nursing job in Camden, Maine. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: 11/09/2026 Duration: 8 weeks 40 hour...

HCS 247 is seeking a travel nurse RN Case Manager, Utilization Review for a travel nursing job in Arcata, California. Job Description & Requirements Specialty: Utilization Review Discipline: RN Start Date: ASAP Duration: 13 weeks 40...

ownership of a case management program(s) pre- authorization reviews to provide Medically Necessary timely and quality health... care services in the most cost-effective manner and pharmacy reviews per population served.We recruit retain and advance...

About this Job: General Summary of Position Responsible for evaluating the necessity appropriateness and efficiency of the use of medical services procedures and facilities. Responsible for clinical review of all acute services for appropr...

Social Worker - Clinical Review Team Lead Setting: Healthcare Facilities Job Type: Contract - Full Time Pay: $32 / Hour Hours: 39.00 Location: Augusta, ME The Social Worker - Clinical Review Team Lead collaborates with the multi...

. Collaborate on training for Operations staff on findings of reviews and audits. Perform other duties as assigned...

required for highly-complex and/or escalated reviews, and providing expert guidance to team members and partnering with the health care... and/or escalated reviews, and providing expert guidance to team members and partnering with the health care team, members...

**Warehouse/Shipping/Production Opportunities!** You will assist in the distribution and shipping operations of home goods products. Fast Scheduling - When you apply with Marathon, you could be working in a few days (depending on curren...

**Warehouse/Shipping/Production Opportunities!** You will assist in the distribution and shipping operations of home goods products. Fast Scheduling - When you apply with Marathon, you could be working in a few days (depending on curren...

to prospective and participating contractors through formal training sessions, on-site reviews, correspondence, or via the telephone...

, an Auditor gathers or assists in gathering financial evidence; performs audits, examinations and reviews of financial evidence...

Audit reviews. Identify overcharges, undercharges and unbundled items. Identify unbundled items on the itemized bill...

actions. Key Responsibilities: Receives, researches, reviews, and analyzes professional and institutional claims using...

claims through email and phone support. Conduct Dealer Self-Reviews (DSRs), document findings, and communicate results...

include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA... Quality Department. Key Responsibilities: Conduct thorough medical record reviews using proprietary tools and software...

) Reviews patient chart on day of admission or first day after admission for SI/IS. C) Completes Advance Directive form... assists in development of patient care and teaching plan. G) Completes InterQual reviews and reveiws care and progress...

. Reviews logs, metrics and research issues with supervising staff Troubleshoots and identifies trends and recommends process...

. Research, innovate and propose metrics, analyses, tools or process changes to improve operation. Reviews and ensures...

administration work keeps online content reviews visible; the content owner decides what is accurate and which changes may...

: Conduct utilization reviews of patient records to assess medical necessity and appropriateness of care. Collaborate...