- INTEGRIS Health (Oklahoma City, OK)
- …recent clinical experience in a variety of clinical settings * Case management experience preferred * Excellent interpersonal communication and collaboration skills. ... discharged from the hospital have a follow-up appointment with his/her provider and review any unmet needs prior to appointment. * Conducts a full assessment… more
- Saint Francis Health System (Tulsa, OK)
- …study visit documentation and/or assessments are completed. Completes and maintains Case Report Forms, Clinical Trial Regulatory Binder(s), and source documents. 2. ... to the IREB and the sponsor for approval. Submits study changes and continuing review to IREB. Submits to the IREB and study sponsor all serious and/or unexpected… more
- Tidal Basin Group (Honolulu, HI)
- Case Reviewer (Honolulu, HI) Honolulu, HI Temporary Experienced Share (https://tidalbasin.applytojob.com/app/share/48stxoO5kT) THIS IS A TEMPORARY EMPLOYMENT ... OPPORTUNITY Position Summary: Tidal Basin seeks a competent Case Reviewer to join the team supporting...of cases, coordinate with partner agencies (FEMA, ARC) to review cases for certain criteria. + Provide reporting as… more
- City of New York (New York, NY)
- …The Office of Constituent Services (OCS) is seeking (1) Eligibility Specialist II to function as Case Reviewer . The Case Reviewer will: - Respond to ... (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)
- …for (1) one Principal Administrative Associate II to function as a Quality Control Case Reviewer , who will: - Conduct the preliminary monthly review ... the review sample by conducting preliminary WMS inquiries and case review ; utilize reports to verify that sample is auditable; identifies inconsistencies,… 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
- CACI International (Bowie, MD)
- DHS Experienced Case Reviewer Job Category: Investigation Time Type: Full time Minimum Clearance Required to Start: Top Secret Employee Type: Regular Percentage ... employees and contractors for security clearances. **POSITION** **SUMMARY:** The Reviewer scrutinizes reports of investigations submitted by Contract Field… more
- CACI International (Chantilly, VA)
- Case Reviewer (Experienced) Job Category: Investigation Time Type: Part time Minimum Clearance Required to Start: Top Secret Employee Type: Part-Time On-Call ... some of the nation's most sensitive missions. **POSITION SUMMARY:** The Reviewer scrutinizes reports of investigations submitted by Field Investigators and Record… more
- City of New York (New York, NY)
- …Office of Constituent Services (OCS) is seeking (2) Eligibility Specialist II's to function as Case Reviewers. The Case Reviewer will: - Respond to inbound ... (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)
- …is recruiting for (1) one Supervisor of Nurses to function as a Complex Medical Case Reviewer , who will: - Conduct medical reviews and analyses claims to ... calculate injury related Medicaid liens pursuant to SSL-104b on cases involving Medical malpractice, mass medical torts, lead paint poisoning, traumatic brain injury, or other catastrophic or medically complex cases. - Consult Medicaid payment records, bills… 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)
- …information to ensure that data collected is complete, accurate and appropriate to the case under review . - Prepare manual budgets to replicate the actual ... Administrative Associate II to function as a Quality Control Case Reviewers, who will: - Be responsible for the...information in order to determine if discrepancies exist. - Review POS, HRA One Viewer of imaged/scanned documents, Welfare… 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 ... for (2) two Principal Administrative Associates IIIs, who will function as Senior Case Reviewers: - Conduct legally mandated case reviews to comply with… 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
- Public Consulting Group (Columbus, OH)
- …reflection of our clients and the people they serve. **Responsibilities** **Onsite Reviewer (OH Department of Medicaid) in Ohio** **(Location - Cleveland/ Akron/ ... Canton/Youngstown/Columbus area)** **Onsite Reviewer Job Description:** The overarching responsibility for this position...by the Ohio Department of Medicaid (ODM). The Onsite Reviewer will operate on a solo basis, within a… more
- Centers Plan for Healthy Living (Margate, FL)
- RN - Grievance and Appeals Clinical Reviewer 5297 W Copans Rd, Margate, FL 33063, USA Req #461 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to ... need for healthy living. JOB SUMMARY: The Grievance & Appeal Clinical Reviewer performs complex medical necessity reviewed on Initial Adverse Determinations or… more
- Kepro (Lombard, IL)
- …the public sector. Acentra seeks an Internal Medicine or Family Practice Physician Reviewer (Illinois Remote, PRN) to join our growing team. Job Summary: The ... Internal Medicine or Family Practice Physician Reviewer will provide principal leadership and clinical expertise to...and clinical expertise to operations relating to the peer review process, utilization review activities, and other… more
- Centers Plan for Healthy Living (Queens, NY)
- Physical Therapy Reviewer Jamaica, Queens, NY, USA Req #1050 Monday, June 3, 2024 Centers Plan for Healthy Living's goal is to create the ultimate healthcare ... their home to improve their quality of life. The Utilization Management Reviewer will assess and process Therapy authorization requests to determine medical… more
- Guthrie (Binghamton, NY)
- …Management (Days) Full Time Position Summary: The Utilization Management (UM) Reviewer , in collaboration with other internal and external offices, payors, and ... authorization/certification for reimbursement of patient care services. The Utilization Reviewer : * Secures authorization as appropriate * Documents payer… more
- Office of the Director of National Intelligence (Mclean, VA)
- …Intelligence (DI) is seeking an energetic officer to serve as a Tradecraft Reviewer in a group focused on analytic and multimedia productoin. This position requires ... receive the highest quality finished intelligence in a timely fashion. Review all-source analytic products-including for the President's Daily Brief and the… more
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