-quality patient care by effectively communicating with management teams, physicians, and the Medical Director. Requirements... with Microsoft tools such as Word, Excel, PowerPoint, and Outlook. Background in medical or clinical practice through education...
-quality patient care by effectively communicating with management teams, physicians, and the Medical Director. Requirements... with Microsoft tools such as Word, Excel, PowerPoint, and Outlook. Background in medical or clinical practice through education...
. Their responsibilities include assessing medical necessity, coordinating care, conducting utilization reviews, providing recommendations... members. Input and manage essential clinical details within various medical management platforms. Keep up...
. Their responsibilities include assessing medical necessity, coordinating care, conducting utilization reviews, providing recommendations... members. Input and manage essential clinical details within various medical management platforms. Keep up...
targeted reviews and audits of research compliance issues in consultation with the Director of Biomedical and Research Ethics... targeted reviews and audits of human subjects research to address IRB-related concerns about compliance with federal and state...
, and intercept daily inquires. Reviews medical record for presence of accurate placement orders and reconciles variances... of clinical reviews to payers. Obtains inpatient authorizations from payers to support level of care and inpatient...
, and intercept daily inquires. Reviews medical record for presence of accurate placement orders and reconciles variances... of clinical reviews to payers. Obtains inpatient authorizations from payers to support level of care and inpatient...
needs of our members. Responsibilities: Reviews and evaluates medical or behavioral eligibility regarding benefits... review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive...
termination of access. Assists with filing and facilitation of quarterly audits. Assists Director with compliance to the Medical... Staff ACHC chapter. Assists Director and Credentials Coordinator with updates to privilege criteria and Medical Staff...
of processes and policies in collaboration with the COH-ATL Cellular Therapies Medical Director and Operations leadership. The... that powers its work. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations...
The Utilization Review Coordinator 2 reviews medical records of clients who are receiving treatment for mental illness... and medical necessity of treatment in relation to federal, state, contractual, and county regulations. Reviews and assesses...
. 14. Assists the Regional Director of Quality Risk & Utilization Management and/or the Manager of Medical Management.... Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion...
. 14. Assists the Regional Director of Quality Risk & Utilization Management and/or the Manager of Medical Management.... Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion...
. Researches information via Cerner and Crimson, for clinical variation reporting and bundle payments. Performs focus reviews... of cases that have identified quality issues. Reviews, organizes and oversees the Medical Staff Peer review activities/meetings...
. Researches information via Cerner and Crimson, for clinical variation reporting and bundle payments. Performs focus reviews... of cases that have identified quality issues. Reviews, organizes and oversees the Medical Staff Peer review activities/meetings...
necessity reviews. Using clinical knowledge and experience, the clinician reviews provider requests for inpatient and outpatient... guidelines to authorize services and appropriately identify and refer requests to the Medical Director when indicated. Behavioral...
. Job Duties Complete all inpatient admission and observation reviews for all medical inpatient units, with priority being... if any reviews were not able to be completed/sent, as well as reason(s) why, such as incomplete provider notes. Assists the Director...
to include medical record reviews with an emphasis on identification of opportunities for system and process improvements. The...Overview: Medical, Dental and Vision Insurance Premiums Paid by Employer! Up to $20,000 sign-on bonus Min...
quality of healthcare to include medical record reviews with an emphasis on identification of opportunities for system...Job Description: Overview Medical, Dental and Vision Insurance Premiums Paid by Employer! Up to $20,000 sign...
technicians, support staff and administration. We are currently seeking a forward thinking and talented Director of Utilization... Review to be part of our Leadership Team. The Director of Utilization Management is responsible for directing and overseeing...