Role Overview As a Generalist, you will leverage your diverse background to review, assess, and provide structured feedback on domain-specific documents. This role is ideal for professionals with strong analytical skills and expertise in co...

Role Overview As a Generalist, you will leverage your diverse background to review, assess, and provide structured feedback on domain-specific documents. This role is ideal for professionals with strong analytical skills and expertise in co...

Role Overview As a Generalist, you will leverage your diverse background to review, assess, and provide structured feedback on domain-specific documents. This role is ideal for professionals with strong analytical skills and expertise in co...

Current UC employees must apply internally via SuccessFactors Next Lives at the University of Cincinnati Founded in 1819, the University of Cincinnati ranks among the nation’s best urban public research universities. Home to more than 5...

GENERAL SUMMARY: Under minimal supervision, reviews and screens the appropriateness of services, the utilization... identify issues throughout the hospitalization to improve the utilization of hospital resources. 9. Reviews and provides...

Management (OCRM) by performing detailed reviews of 7(a) and 504 loan files as part of SBA’s lender oversight and risk management... virtual data warehouse and workflow tracking system to manage file reviews, maintain work papers, and support status reporting...

, such as MCG criteria to complete initial and continued stay reviews in determining appropriate admission and continued stay status... basis. Performs retrospective reviews. Reviews all commercial accounts daily or as per contract or payer expectation...

, during, and after services to ensure level of care and services are medically appropriate Performs prior authorization reviews related...

, and patient satisfaction. Job Description Essential Functions Performs admissions and continued stay reviews...

and their families. What You'll Do: Conduct independent, remote case reviews evaluating medical necessity, appropriateness, or quality... complexity Most cases take 1-3 hours to complete; shorter reviews may take less than 1 hour Strong written communication skills...

Management (OCRM) by performing detailed reviews of 7(a) and 504 loan files as part of SBA’s lender oversight and risk management... a secure, web-based virtual data warehouse and workflow tracking system to manage file reviews, maintain work papers...

review and provide clearance on potential negative news alerts for new clients or during periodic client reviews. Perform... prospect client reviews and provide recommendations prior to onboarding prospects as well as other referrals from line units...

Job Description: Job Description Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient... organizations, external reviews, and other payers. Communicate with physicians to schedule peer to peer reviews. Accurately report...

, familiar with current rules and regulations, licensed to work in CA. Position Purpose: Performs clinical reviews... in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Prepares case reviews...

with agency staff, and performs related work as required. Reviews appeals and, when possible, obtains additional evidence... within a timeframe that is reasonable and attains the DOL guidelines for promptness. Reviews cases prior to and after the hearing...

and implementation of human research protection for all NTR IRB partners; 2) Perform comprehensive administrative and regulatory reviews... and regulatory reviews of designated IRB submissions (which include biomedical, clinical trial and social/behavioral science studies...

reviews for mental health services. Clinicians who reside in Arkansas or have knowledge of Arkansas specific resources... level of care and services are medically appropriate Performs prior authorization reviews related to mental health...

authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance...

our global risk reviews. Who you are 4+ years experience in Customer Due Diligence/Enhanced Due Diligence/KYC...

in Redmond. This position is responsible for a broad range of advanced-level plan reviews related to the enforcement...