• Eclaro (NY)
    …is one of the world's largest reinsurance firms, providing Property & Casualty, Life and Health Insurance to its clients. If you're up to the challenge, then ... by Merrill Lynch Commuter Check Pretax Commuter Benefits Eligibility to purchase Medical , Dental & Vision Insurance through ECLARO If interested, you… more
    JobGet (01/06/25)
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  • Eclaro (Scotch Plains, NJ)
    …by Merrill Lynch Commuter Check Pretax Commuter Benefits Eligibility to purchase Medical , Dental & Vision Insurance through ECLARO If interested, you ... procedures, such as CSV SOP but no limited and applicable health authority regulations. Required Qualifications: Sound understanding of Electronic Batch Records… more
    JobGet (01/06/25)
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  • Utilization Review Manager-Selikoff Centers…

    Mount Sinai Health System (New York, NY)
    …The Utilization Review Manager for the Selikoff Centers for Occupational Health is responsible for the management of program operations within a particular ... service standards of the Hospital and the Nursing Department. + Performs utilization review in accordance with all regulations, using health plan management tool… more
    Mount Sinai Health System (10/31/24)
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  • Utilization Review Specialist, Behavioral…

    Sutter Health (Berkeley, CA)
    …reporting content and format. May perform trending and create summary reports. + Review medical records documentation in response to denials or authorizations ... management activities for the assigned area. Collaborates with hospital administration, medical staff, patient registration and representatives of review more
    Sutter Health (10/24/24)
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  • Senior Director, Medical Review (MR)

    Gilead Sciences, Inc. (Foster City, CA)
    …**Job Description** Job Description You will establish visions and objectives for the Medical Review (MR) group taking into consideration of the departmental ... lead the MR group to deliver timely and high-quality medical review , ensure the MR process and...time off, and a benefits package. Benefits include company-sponsored medical , dental, vision, and life insurance plans*.… more
    Gilead Sciences, Inc. (10/18/24)
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  • Medical Review Manager

    Serco (VA)
    …in CPC/CCS certification course + 3 years of supervisory/managerial experience in the health insurance industry, a utilization review firm, or another ... **Position Description** Serco is seeking a motivated Medical Review Manager to join our... health care claims processing organization involving medical and coding reviews of a variety of … more
    Serco (12/07/24)
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  • Senior Manager, US Medical Ad/Promo…

    Takeda Pharmaceuticals (Lexington, MA)
    …to the best of my knowledge. **Job Description** **Senior Manager, US Medical Ad/Promo Regulatory Review ** **Takeda Pharmaceutical** **Lexington, MA or Exton, ... the role:** Join Takeda as a Senior Manager, US Medical Ad/Promo Regulatory Review where you will...US based employees may be eligible to participate in medical , dental, vision insurance , a 401(k) plan… more
    Takeda Pharmaceuticals (11/15/24)
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  • Quality Officer I (Inpatient Coding Review

    RWJBarnabas Health (Oceanport, NJ)
    …physical, emotional, social, and financial health . + Paid Time Off (PTO) + Medical and Prescription Drug Insurance + Dental and Vision Insurance + ... Review ) - Hybrid/RemoteReq #:0000138249 Category:Coder Status:Full-Time Shift:Day Facility:RWJBarnabas Health Corporate Services Department:HIM - Coding South Location: System… more
    RWJBarnabas Health (11/18/24)
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  • Research Charge Review Specialist

    Premier Health (Dayton, OH)
    …ensure proper compliance and reimbursement. Engaged in proactive and independent line-item review of charge related items/encounters within Premier Health in ... Full-Time / 8:00am - 5:00 pm The Research Charge Review Specialist is responsible for reviewing and validating all...the new CMS Clinical Research Policy + Knowledge of medical and insurance terminology, CPT, ICD coding… more
    Premier Health (01/03/25)
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  • Coordinator, Institutional Review Board…

    UT Health (Houston, TX)
    Review Board - Research Compliance Office **Location:** Texas Medical Center-Houston, Texas **Hot** **Category:** Research UTHealth Houston General Administration ... package includes the benefits you'd expect from a top healthcare organization (benefits, insurance , etc.), plus: + 100% paid medical premiums for our full-time… more
    UT Health (11/27/24)
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  • RN-Utilization Review

    Ascension Health (Baltimore, MD)
    …providers, patients, and insurance companies to explain utilization review decisions.** **Familiarity with electronic health records and utilization ... management software.** **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans… more
    Ascension Health (12/28/24)
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  • Case Manager with Utilization Review

    Beth Israel Lahey Health (Burlington, MA)
    …Manager experience as well as Utilization Review experience ( review medical necessity and discharge planning) **As a health care organization, we have ... making a difference in people's lives.** Joint role of Case Manager and Utilization Review Nurse Onsite at Lahey Hospital and Medical Center in Burlington… more
    Beth Israel Lahey Health (12/10/24)
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  • RN Peer Review Specialist - Sioux Falls or

    Sanford Health (Fargo, ND)
    …full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance , dental insurance , vision insurance , life ... **Careers With Purpose** **Sanford Health is one of the largest and fastest-growing...monitoring activities to persons and committees for use in Medical Staff peer review processes and activities… more
    Sanford Health (12/03/24)
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  • Surgical Review Specialist,…

    St. Luke's University Health Network (Allentown, PA)
    …the communities we serve, regardless of a patient's ability to pay for health care. The Surgical Review Specialist prospectively reviews, validates, and audits ... registrations and/or physician queries + Serves as liaison between Physician Advisor/ Medical Director, Finance, Utilization Review Department and CDCI. PHYSICAL… more
    St. Luke's University Health Network (10/31/24)
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  • Manager, Care Coordination - Utilization…

    Stanford Health Care (Palo Alto, CA)
    …readmissions? Then, join us and make SHC your career home. Our core benefits include medical insurance , dental insurance , vision insurance , an employee ... program, savings and spending accounts, disability, life and accident insurance , and COBRA. For medical insurance...insurance , you have the choice of three generous health plans through Stanford Health Care Alliance,… more
    Stanford Health Care (11/20/24)
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  • Utilization Review - Denial Coordinator

    Methodist Health System (Celina, TX)
    …clinical outcomes. The above is accomplished through the use of medical staff or organizational accepted criteria for determining appropriateness for admission, ... discharge/transition planning. Participates in ongoing clinical improvement, hospital, and medical staff quality initiatives while supporting the mission, vision,… more
    Methodist Health System (12/05/24)
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  • Utilization Review Specialist

    CaroMont Health (Gastonia, NC)
    …daily reviews of medical necessity will be performed and documented in medical review , including daily status update while patient is in observation status. ... Job Summary: Completes initial review for medical necessity for all...physicians regarding utilization issues. Assign patients that have had insurance verified to the UR Specialists on Provider Link.… more
    CaroMont Health (10/26/24)
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  • RN Manager-Utilization Review

    Ascension Health (Baltimore, MD)
    …willing to obtain within 1 year.** **Benefits** Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer ... processes, including management of patient statusing processes and monitoring of medical necessity review functions for assigned sites. + Collaborate with… more
    Ascension Health (12/17/24)
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  • Clinical Review Manager, Hospice Home Care

    VNS Health (Manhattan, NY)
    …time off (PTO), starting at 30 days of paid time off and 9 company holidays + Health insurance plan for you and your loved ones, Medical , Dental, Vision, ... OverviewThe Hospice Clinical Review Manager's primary responsibility is ensuring compliance with...with clinical staff and management required CAREERS AT VNS Health The future of care begins with you. Together,… more
    VNS Health (12/05/24)
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  • Clinical Quality Review Specialist - RN…

    Trinity Health (Livonia, MI)
    …Learn the industry's best, easy-to-use, advanced technology **Other benefits** + First day Medical , dental and vision insurance + Short and long-term disability ... **Employment Type:** Full time **Shift:** **Description:** Trinity Health at Home is seeking an experienced RN...Home is seeking an experienced RN remote Clinical Quality Review Specialist with ICD10 HCS-D certification which is Required.… more
    Trinity Health (12/10/24)
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