Responsibilities The George Washington University Hospital (GW Hospital) continues to be a leader in providing the highest level of quality and compassionate healthcare for the D.C. Region. U.S. News & World Report has just released the 2...

Registered Nurse (RN) | Utilization Review Location: Glendale, CO Agency: Adelphi Healthcare Pay: $46 per hour Contract Duration: 1 Years Start Date: ASAP About the Position TravelNurseSource is working with Adelphi Healthcare to find a...

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

build and drive a data-powered feedback loop for engineering design reviews, leveraging cutting-edge tools like CoLab... effectiveness of AI-driven reviews Translate engineering standards into structured checklists and AI-driven validation rules...

Coordination Rounds and identifies and communicates barriers to efficient utilization. Reviews H&Ps and admitting orders...

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

exception tracking system Work to continually develop and improve internal procedures Assist with collateral reviews...

loans. Performs loan quality reviews to ensure compliance with policy, procedure, and regulation. Request additional...

Site Reviews and Medical Records Reviews for the UCLA Medical Group provider network. This role supports compliance... initiatives. Key Responsibilities Coordinate and oversee Facility Site Reviews and Medical Records Reviews for provider sites...

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

organizations. Facilitates audits and reviews the policies, processes and related transactions of all banking organizations...

standards and regulatory requirements. The analyst reviews contracts, Statements of Work (SOW), and Data Processing Agreements... Participate in security reviews to evaluate and validate the effectiveness of security controls Provide technical expertise...

experience with case management and the utilization review process including concurrent reviews. Previous continuum of care...

experience with case management and the utilization review process including concurrent reviews. Previous continuum of care...

appropriately. Medical necessity reviews for designated services are completed for all Priority Health plans. Assesses...

of admissions, initial and continued stay reviews to the insurance company via EPIC or online portals. Actively monitors...

on Director's Review Case Management Conduct Director Reviews for position allocations, removal of names from layoff lists... and respond promptly to DR inbox inquiries. Conduct peer reviews of DR determinations. Prepare cover letters and distribute...

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

to ensure level of care and services are medically appropriate Performs prior authorization reviews related to mental health...

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