- Graham Windham (Brooklyn, NY)
- Case Record Reviewer Job Details Job Location 1 PIERREPONT PLAZA SUITE 901 - BROOKLYN, NY Position Type Part Time Education Level 4 Year Degree Salary Range ... and develop program resources. About the Position PPP seeks a part-time Case Record Reviewer to support our Enhanced Family Foster Care (EFFC) and Family Support… more
- City of New York (New York, NY)
- …is recruiting for (1) one Principal Administrative Associate II to function as a Quality Control Case Reviewer , who will: - Ensure the accuracy of the review ... by conducting preliminary WMS inquiries and case review ; utilize reports to verify that sample is auditable;...review and share documents with the Quality Control Case Review Supervisor to ensure the appropriateness… more
- City of New York (New York, NY)
- …the final report. CA PERT Sr. Reviewer prepares lawsuit packets for each case in the review for electronic transmission to NYC Corporation Counsel. - Conduct ... during customer interaction, and determine whether appropriate action was taken. - Review case file information, POS entries and WMS data to report on the… more
- City of New York (New York, NY)
- …for (1) one Principal Administrative Associate II to function as a NCA PERT Case Reviewer , who will: - Conduct NCA Supplemental Nutrition Assistance (SNAP) ... customer interaction and determine whether appropriate action was taken. - Review case file information, Paperless Office System (POS) entries and Welfare… more
- CACI International (VA)
- Case Reviewer (Experienced) Job Category: Investigation Time Type: Full time Minimum Clearance Required to Start: Top Secret Employee Type: Regular Percentage of ... some of the nation's most sensitive missions. **POSITION SUMMARY:** The Reviewer scrutinizes reports of investigations submitted by Field Investigators and Record… more
- Point32Health (MA)
- …to our members, partners, colleagues and communities. **Job Summary** The Clinical Reviewer , Inpatient RN, is a licensed professional that is expected to function ... subacute, acute rehabilitation, LTAC, CORF and others. The Clinical Reviewer , Inpatient RN is responsible for making the determination...may not be limited to DRG (APR and MS), case rate and/or per diem reimbursement models. The Clinical… more
- City of New York (New York, NY)
- …be eligible for continued employment. The Office of Constituent Services /Ombudsman Case Reviewer within the Medicaid Eligibility Information Services (EIS) is ... /Ombudsman is seeking two (2) Eligibility Specialist II's to function as EIS Case Reviewers who will: - Respond to inbound and outbound telephone calls received… more
- City of New York (New York, NY)
- …for (2) two Principal Administrative Associates II to function as a Quality Control Case Reviewers, who will: - Review POS, HRA One Viewer of imaged/scanned ... to ensure that data collected is complete, accurate and appropriate to the case under review . - Prepare manual budgets to replicate the actual amounts issued to… more
- City of New York (New York, NY)
- …legal and federal, state and city regulatory requirements. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... Assurance & Fiscal Integrity (OQA&FI) / The Process Evaluation Review Team (PERT) is recruiting for (2) one Principal...one Principal Administrative Associates III, to function as Senior Case Reviewers who will: - Conduct legally mandated … more
- City of New York (New York, NY)
- …THE PRINCIPAL ADMINISTRATIVE ASSOCIATE CIVIL SERVICE TITLE. The Process Evaluation Review Team (PERT) is tasked with aggressively monitoring program compliance with ... recruiting for one Principal Administrative Associates IIIs, who will function as Senior Case Reviewers: - Conduct legally mandated case reviews to comply with… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …as appropriate. At the request of the Senior Medical Director of the Physician Review Unit (PRU), the reviewer also provides clinical leadership in other areas ... anticipatory case management for members whose cases come for review , identifying opportunities for improved care coordination and placing internal BCBSMA … more
- State of Colorado (Denver, CO)
- …services systems. Specifically, the ARD is the mechanism responsible for the federally required Case Review System and a portion of the Quality Assurance System ... Administrative Reviewer Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4814082) Apply Administrative Reviewer...Welfare Quality Assurance: + The federally required child welfare Case Review and Qualitative Case … more
- Robert Half Legal (Miami, FL)
- …legal immigration industry, based in Miami, Florida. Your main role will be to review case documents, make necessary changes in assembled files, and perform ... * Carry out minor modifications on forms * Use Case Management Software to keep track of all cases...to keep track of all cases Requirements * Immigration case reviewing * Proficient use of Case … more
- Apex Health Solutions (Houston, TX)
- …as a contact and resource person to Health Solutions' members for the utilization review (UR) of healthcare services. The UM Reviewer will be responsible for ... the UM Reviewer should also identify enrollees in need of case /disease management services so that proactive interventions can occur. Essential Duties and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …At the request of the Associate Medical Director of the Physician Psychologist Review Unit, the Reviewer also provides clinical leadership in other areas ... healthcare? Bring your true colors to blue. The Physician Reviewer is responsible for evaluating clinical service requests made...case management for members whose cases come for review , in partnership with case managers +… more
- City of New York (New York, NY)
- …medical and mental health policies, programs, and initiatives that support best case practice agency wide. The Medical Review Authorization and Monitoring ... the health care provided is comprehensive and appropriate. OCFH also offers individualized case consultations and training to ACS staff and foster care agencies on a… more
- BayCare Health System (Tampa, FL)
- …Occasional + **On Call:** No + Remote The role of the Utilization Physician Reviewer is to optimize utilization physician review coverage resulting in reduction ... utilization in the acute care setting through collegial interaction with Utilization Review , Case Management, and Clinical Providers while aligning with… more
- Henry Ford Health System (Jackson, MI)
- …Conducts audits of perioperative charges for Henry Ford Jackson Hospital. Defends charges (revenue) challenged by third-party insurance companies, ensures documented ... charges are correctly billed and are documented in EPIC. Proposes corrective action in charge capture problem areas. Participates in Clinical operational reviews. EDUCATION/EXPERIENCE REQUIRED: + High School diploma or GED equivalent is required in order to… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …healthcare? Bring your true colors to blue. The Role The Clinical Utilization Reviewer is responsible for facilitating care for members who may have complex ... our Hingham, MA office. The Team The Clinical Utilization Reviewer is part of a highly dedicated and motivated...: + Conduct pre-certification and concurrent and retrospective clinical review of in-state and out-of-state inpatient cases at acute… more
- Cleveland Clinic (Cleveland, OH)
- Utilization Management (UM) RN Reviewer - Behavioral Health Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide ... Utilization Management RN Reviewers perform UM activities including admission review , concurrent review , retrospective chart review...to provide evidence that the UR process for the case was followed. + Design and initiate special projects… more