to consult on the level of care and duration of treatment required for complex and/or escalated reviews, and providing guidance..., and providing oversight for desk-level procedures (e.g., workflows). Performs utilization reviews by: following standard...

to consult on the level of care and duration of treatment required for complex and/or escalated reviews, and providing guidance..., and providing oversight for desk-level procedures (e.g., workflows). Performs utilization reviews by: following standard...

to consult on the level of care and duration of treatment required for complex and/or escalated reviews, and providing guidance..., and providing oversight for desk-level procedures (e.g., workflows). Performs utilization reviews by: following standard...

. Documentation and Reporting: Document findings from utilization reviews in the appropriate systems and ensure accurate record...

. Documentation and Reporting: Document findings from utilization reviews in the appropriate systems and ensure accurate record...

Stroke response times nearly half of the national average. Cutting-edge SPOT Technology that detects sepsis earlier than the human eye. An Enhanced Surgical Recovery program that reduces opioid prescriptions and post-surgical readmissions. ...

Stroke response times nearly half of the national average. Cutting-edge SPOT Technology that detects sepsis earlier than the human eye. An Enhanced Surgical Recovery program that reduces opioid prescriptions and post-surgical readmissions. ...

Stroke response times nearly half of the national average. Cutting-edge SPOT Technology that detects sepsis earlier than the human eye. An Enhanced Surgical Recovery program that reduces opioid prescriptions and post-surgical readmissions. ...

. Documentation and Reporting: Document findings from utilization reviews in the appropriate systems and ensure accurate record...

responsible for conducting post-service in-depth clinical reviews (all care settings) in accordance with accepted standards... expertise to conduct clinical case retrospective reviews to determine deviation from standard of care or gaps in care...

process. How you’ll make an impact in this role Improves patient safety by coordinating objective case reviews...

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

. Reviews physician medical record documentation and consults with physicians regarding completeness. Minimum Qualifications... InterQual criteria to assess for appropriate level of care assignment. Reviews both inpatient admissions and patients placed...

throughout the product lifecycle. Partner with Integrated Product Teams (IPTs) and participate in design reviews. Support...

expertise by supporting Integrated Product Teams (IPT) and participating in design reviews. Lead on-site disabled product...

and implements product/process improvements. Supports Integrated Product Teams (IPT) and participates in design reviews. Represents...

Responsibilities Include: Contract reviews - review and revise contracts improving or eliminating exposure, review...

. Candidates must have a CA license. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical... Responsibilities: MAJOR DUTIES AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review...

. Effectively communicates credit risk reviews objectives, outcomes and recommendations for issue remediation as needed. Analyzes...

. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical interpretation and decisions about the... AND RESPONSIBILITIES: Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity...