- Bristol Myers Squibb (Madison, NJ)
- …advisors/stakeholders on issues or concerns + Ability to demonstrate leadership within the medical review team to help drive best practices aligned with ... more
- ConvaTec (South Easton, MA)
- …guideline requirements needed to set up and maintain client accounts of 180 Medical . + Review received documentation to determine insurance requirements are met. ... more
- Robert Half Accountemps (Los Angeles, CA)
- Description A Medical IPA Group in Los Angeles is in the immediate need of a Medical Claims Review Coordinator. The Medical Claims Review ... more
- Takeda Pharmaceuticals (Lexington, MA)
- …best of my knowledge. **Job Description** **About the role:** Join Takeda as a Medical Information & Review Manager where you will deliver high-quality, balanced ... more
- Intermountain Health (Las Vegas, NV)
- …for the position.** Performs medical review activities pertaining to utilization review , claims review , quality assurance, and medical review ... more
- The Arora Group (Bethesda, MD)
- …providers in gathering clinical information and may also provide education on the medical review process. + The Contractor performing as the License Practical ... more
- Independent Health (Buffalo, NY)
- …and collaboration. **Overview** The Utilization Review Nurse (URN) performs clinical review to determine the medical necessity of requested services. The URN ... more
- City of New York (New York, NY)
- …appropriate, negotiate and settle claims within delegated monetary authority level; 8) Review medical providers and law firms to ensure all entities are in ... more
- TEKsystems (Bakersfield, CA)
- Remote Medical Claims Examiner This role will...accurate claim payment. . Coordinate with the medical review team for cases requiring clinical ... more
- Travelers Insurance Company (Morristown, NJ)
- …This position is responsible for handling Personal and Business Insurance First Party Medical claims from the first notice of loss through resolution/settlement ... more
- Travelers Insurance Company (Orlando, FL)
- …intended to develop skills for investigating, evaluating, negotiating and resolving First Party Medical claims on losses of lesser value and complexity. Provides ... more
- Emanate Health (Covina, CA)
- …decisions using indicated protocol sets, or clinical guidelines and provide support and review of medical claims and utilization practices. Complete ... more
- AbbVie (Mettawa, IL)
- …within Medical Affairs + Health Impact (MHI) organization, including Medical Review , Scientific Platform, CFL (consistent with the FDA-required labeling), ... more
- Humana (Columbus, OH)
- …will understand how to operationalize this knowledge in their daily work. The Medical Director's work includes computer-based review of moderately complex to ... more
- Travelers Insurance Company (Columbus, OH)
- …which can impact claim outcomes. Organize and coordinate Travelers' medical review functions. This includes interpreting Federal and State regulations ... more
- The Cigna Group (Bloomfield, CT)
- …is responsible for primary care center. Requires an MD, DO or DC. SUMMARY: The Medical Director performs medical review and case management activities. The ... more
- Equitable (Charlotte, NC)
- Clinical Review Nurse, Disability Claims ( 25000067 ) **Primary Location** : UNITED STATES-NC-Charlotte **Other Locations** : UNITED STATES-Remote, UNITED ... more
- The County of Los Angeles (Los Angeles, CA)
- …direction, administrative and technical supervision over the nursing staff engaged in utilization review activities at Los Angeles General Medical Center, one of ... more
- ManpowerGroup (Columbia, SC)
- …(80%)** + Perform medical reviews using established criteria and guidelines. + Review medical claims and determine reasonable charge payments. + Ensure ... more
- MTA (New York, NY)
- …marshals regarding incidents that occur on LIRR property. + Secure and review medical reports, confirm accident status & authorization for diagnostic ... more
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