- AmeriHealth Caritas (Philadelphia, PA)
- **Clinical Care Reviewer , Pediatric Shift Care, Registered Nurse** Location: Philadelphia, PA Primary Job Function: Medical Management ID**: 34518 Your career starts ... **Responsibilities:** Under the direction of the unit Supervisor, the Clinical Care Reviewer - Shift Care is responsible for managing requests for pediatric shift… more
- AECOM (Sacramento, CA)
- …a better world. Join us. **Job Description** **AECOM** is seeking an **Assistant Project Manager - Utility Design Reviewer ** to be based in **Sacramento or ... Manager - Reports of Investigation ("ROI") and the Utilities Senior Project Manager , the Utility Design Reviewer contributes alongside a team of Utility… more
- Fluor (CA)
- … Manager - Reports of Investigation ("ROI") and the Utilities Senior Project Manager , the Utility Design Reviewer contributes alongside a team of Utility ... Design Reviewers to prepare, review , coordinate, and track all utility Reports of Investigation...Reports of Investigation for the Authority. The Utility Design Reviewer is responsible for preparing ROI reports in conformance… more
- Corner Alliance (Washington, DC)
- …commitment to deliver, grow and thrive . About the Role: As a Programmatic Reviewer supporting our Federal government client, you will be trusted to provide the ... assess a proposal for its value, quality, and likelihood of success. + Review grants applications, assessing the adequacy of the submission based on the requirements… more
- Point32Health (MA)
- …under the general direction of the Precertification Team Manager or department Manager . The Clinical Reviewer is expected to demonstrate the ability to work ... are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Clinical Reviewer is a licensed Registered Nurse that is expected to function… more
- Louisiana Department of State Civil Service (New Orleans, LA)
- Contracts/Grants Reviewer 1,2,3 - Job Appointment Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4644019) Apply Contracts/Grants Reviewer ... in a Career Progression Group up to a Contract/Grant Reviewer 3. + This position may be filled as...and operationally supports LSM. Foundation agreements are excluded from review /approval by the Department's Office of Management and Finance… more
- Rush University Medical Center (Chicago, IL)
- …patient selection and creation of patient-tracking Excel documents. * Conducts a regular review with the Clinical Quality Program Manager of clinical registries' ... Schedule:** 8 Hr (9:00:00 AM - 5:00:00 PM) **Summary:** The Surgical Clinical Reviewer 's chief responsibility is to oversee and optimize the American College of… more
- Koniag Government Services (Germantown, MD)
- …email only and have not been interviewed by the KGS hiring manager , feel free to contact_ _KGSrecruiting@koniag-gs.com_ _to verify its validity._ **Koniag ... Koniag Government Services company **,** is seeking a Document Reviewer Level 5 (DRL5) with Top- Secret clearance to...weapon science, and military utilization of nuclear weapons to review and assess documents. + Collaborating with team members… more
- Carle (Urbana, IL)
- Licensed Practitioner of the Healing Arts (LPHA) Reviewer + Department: Cert Comm BH Clinic - CTP + Entity: Peoria Service Area + Job Category: Mental Health + ... Save Save Apply Now Position Summary: Under the general supervision of the Manager , Outpatient Community Services will serve as the Licensed Practitioner of the… more
- Magellan Health Services (Honolulu, HI)
- …solutions that directly influence quality of care. General Job Information Title HMSA Care Manager - BH, UM Reviewer - Remote Hawaii Grade 24 Work Experience ... + Maintains an active work load in accordance with National Care Manager performance standards. + Works with community agencies as appropriate. Proposes alternative… more
- Kepro (Nashville, TN)
- …solutions in the public sector. Acentra is looking for a Physician Medical Claims Reviewer to join our growing team. Job Summary: The primary responsibilities of a ... Physician Medical Claims Reviewer include conducting independent medical service appeal reviews for...+ Prepare independent reviews of medical services appeals. + Review records, prepare and submit all reviews in keeping… more
- Brighton Health Plan Solutions, LLC (New York, NY)
- …services, and the evaluation of coverage under the Plan. The Nurse Case Reviewer reports to the Casualty Department Manager . Primary Responsibilities + ... About The Role Brighton Health Plan Solutions (BHPS) provides Utilization Review /Medical and Case Management services for Group Health and Workers' Compensation and… more
- Boston Public Schools (Boston, MA)
- …Program: Child and Adult Care Food Program Positions Available: After-School Food Program Reviewer Commitment Date: August 19, 2024 - June 30, 2025 [program start ... be reviewed at least three times per year. Each review is one hour long. A review ...of the BPS mileage reimbursement policy. Reports to: Nutrition Manager Responsibilities: Ensures that site personnel maintain accurate records… more
- Commonwealth Care Alliance (Boston, MA)
- …under the provisions of CCA's benefits plan. The Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization ... review for medical necessity and decision-making. The Utilization Management Reviewer has a key role in ensuring CCA meets CMS compliance standards in the area of… more
- Commonwealth Care Alliance (Boston, MA)
- …the provisions of CCA's benefits plan. The Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization ... review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS compliance standards in the… more
- City of New York (New York, NY)
- …Constituent Services (OCS) is seeking (1) Eligibility Specialist II to function as Case Reviewer . The Case Reviewer will: - Respond to inbound and outbound ... (NAMI-Net Available Monthly Income) if institutionalized. - Interview and/or review documentation submitted by applicants/recipients (A/R) or authorized representatives,… more
- City of New York (New York, NY)
- Job Description Only candidates who are permanent in the Project Manager title, who are reachable on the Open-Competitive List (Exam #0126), or who filed for ... or indicate if you are permanent in the Project Manager title. If you do not meet the previously...and Construction, Division of Public Buildings seeks a Design Reviewer to work within the Specifications and Bid Packaging… more
- WTW (Boston, MA)
- …of response and report any issues or impact to timeline proactively to Project Manager + Complete initial review of carrier responses for parity projects + ... and client specific responses + Collaborate with MHPAEA senior reviewer and Project Manager to conduct follow...a manner consistent with WTW work processes and peer review standards (eg, filing of drafts, deliverables, client and… more
- ThermoFisher Scientific (King Of Prussia, PA)
- …biopharmaceutical company, all while maintaining full-time benefits. **Description** As a QC Reviewer you will perform a variety of complex analytical review ... other applicable areas. **Essential Functions:** * Performs complex analytical data review , evaluating laboratory data for compliance with analytical methods, SOPs,… more
- Elevance Health (Olathe, KS)
- …miles of our Pulse Point location in Olathe, KS or Topeka, KS The **Therapist Reviewer Sr** will be responsible for the review of medical records, including more ... professional therapy, government regulation and medical policy knowledge to medical review , and makes determinations for authorization requests, meeting all contract… more