- Shasta Community Health Center (Redding, CA)
- …taking. Demonstrate competent knowledge in delivering health care to patients through the peer review processes including chart review , by interactions with ... physician preceptors and by working collaboratively with support staff and all staff of SCHC. Become an integral part of the clinical staff through participation in Medical Staff meetings, PA/NP meetings, and other committees of SCHC. Willingly perform other… more
- Ethos Veterinary Health (Wilmington, NC)
- …Nurse Champion Awards Recover CPR and Fear Free certification initiatives Ethos Peer -to- Peer Mentorship Networks for continued LVT/CVT growth and aspiring VTS ... and communicate with clients regarding their pet's condition, treatment plans, review of estimates, and follow-up care. Other duties as assigned. Requirements:… more
- VitalCore Health Strategies (Hopkinton, MA)
- …direction and assistance to the on-site quality improvement program, including review of grievances and development of corrective action plans involving patients ... care within their assigned contracts. Ensure compliance with re-credentialing Ensure review of patient care information (laboratory results and previous QNXT… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Peer Review Coordinator Location: Hybrid | Eagan, Minnesota Career Area: ... and delivery of a wide variety of services related to BCBSMN peer review services. The position works closely with the Medical Director of Utilization… more
- Ascension Health (Tulsa, OK)
- …Organize and coordinate the activities and flow of work for the peer review program. + Collect, evaluate, and maintain practitioner-specific data ... risk-related data. + Coordinate the medical staff's professional performance evaluation and peer review programs in a manner that fulfills the mission and goals… more
- Sanford Health (WI)
- …Full time **Weekly Hours:** 40.00 **Salary Range:** 31.00 - 49.50 **Job Summary** The Peer Review Specialist facilitates provider peer review processes ... ongoing monitoring activities to persons and committees for use in Medical Staff peer review processes and activities to include case review , Ongoing and… more
- HCA Healthcare (Webster, TX)
- …**Introduction** HCA Houston Healthcare Clear Lake is committed to investing in the latest technology enabling nurses to work more efficiently. **Are you passionate ... about delivering patient-centered care?** Submit your application for Registered Nurse Coord Quality position and spend more time at the bedside with the patient. **Benefits** HCA Houston Healthcare Clear Lake, offers a total rewards package that supports the… more
- NANA Regional Corporation (Oak Ridge, TN)
- …of outstanding professionals, apply today! **Responsibilities** + Development, revision, and peer review of Nuclear Criticality Safety (NCS) documentation such ... documents, participation at facility Operational Safety Boards, etc. + Must be Peer Review qualified. + Staff Augmentation peer review support… more
- State of Connecticut, Department of Administrative Services (East Hartford, CT)
- …of case reviews for quality and appropriate medical management, cost containment, peer review and rehabilitation; + Implement decisions in program according ... disability cases for purpose of determining medical management, cost containment, peer review and rehabilitation; + May notify acute care hospitals of scheduled… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …a managed-care or risk contract environment (committee work, large group practice, or peer review ) + Experience with basic computer programs, including but not ... in conjunction with BCBSMA criteria to adjudicate these requests, engaging in peer -to- peer outreach with treating providers, as appropriate. At the request… more
- Spectrum Billing Solutions (Skokie, IL)
- …authorization for treatment services. + Manage authorization denials including referral for peer review . + Document and record all necessary information. + ... manner. We are seeking to add an ABA Utilization Review (UR) Specialist to our growing team. The ABA...will utilize his or her knowledge and skills to review clinical information and obtain initial and continuing authorizations… more
- Actalent (Rancho Cordova, CA)
- …clinical information when needed + Support denial management, including appeals and peer ‑to‑ peer review processes + Ensure regulatory compliance with ... Utilization Review Nurse About the Role We're looking for a Utilization Review (UR) Nurse to join our team and support high‑quality, cost‑effective patient care… more
- STG International (Rockville, MD)
- …in accordance with professional societies and state regulations . + Participates in FOH peer review process as requested . + Assist in establishing and ... - Reviewing Medical Officer (RMO) for the Law Enforcement and Surveillance Case Review Program for Federal Occupational Health Services (FOH) in Rockville, MD and/or… more
- Healthfirst (NY)
- **Duties//Responsibilities:** + **The Medical Peer Reviewer will assess// review requests for authorization, and claims payment, based on medical records and ... information and make informed clinical judgments and recommendations.** + **The Medical Peer Reviewer will render determinations in the format and within timeframes… more
- Geisinger (Scranton, PA)
- …performance. Involve one-on-one or group review sessions or lab practical review sessions. Peer tutors will offer workshops on general academic skill ... Job Summary Provide peer tutorial assistance to students wishing to improve their academic… more
- HCA Healthcare (Manchester, NH)
- …of any upcoming or ongoing surveys relative to credentialing, privileging and PPE/ peer review activities and functions. Coordinate accreditation, regulatory, and ... any internal surveys relative to credentialing, privileging and PPE/ peer review activities and functions. Respond to any reviews accreditation and regulatory… more
- Sutter Health (Vallejo, CA)
- …approval of leadership. * Manages accreditation readiness staff. Activity: Medical Staff Peer Review Functions. Facilitates and collaborates with medical staff ... leadership and peer review staff to coordinate all aspects of the entity physician peer review program. Functions in a collaborative manner with all… more
- Tenet Healthcare (Detroit, MI)
- …in the case management system Follows the payor dispute processes utilizing secondary medical review , peer to peer and payor type changes (25% daily, ... RN Utilization Review - Case Management - 2506004107 Description :...Management, Managed Care and Business Office to improve concurrent review process to avoid denial or process delays in… more
- The Joint Commission (Oak Brook, IL)
- …Editors for review . Coordinates and ensures the integrity of the double-blinded peer review of articles. Tracks all manuscripts through the submission, ... Handles contracting and payments to external editors as appropriate. **Coordination of Peer Review :** + Reviews all submissions to the journal to determine if… more
- JPMorgan Chase (Columbus, OH)
- The Consumer and Community Banking (CCB) Quality Peer Review (QPR) Program is supported by the CCB Escalations Governance team. The QPR team partners closely ... deliver comprehensive guidelines and ensure consistent quality standards through structured peer review processes. As a QPR Program Governance Associate,… more
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