- Dana-Farber Cancer Institute (South Boston, MA)
- …We conduct groundbreaking research that advances treatment, we educate tomorrow's physician /researchers, and we work with amazing partners, including other Harvard ... for oversight of grant submittal process, including monitoring the application review process and submitting supplemental information. Works with faculty to … more
- Altru Health (East Grand Forks, MN)
- …which correlates to the age of the patient, the patient's diagnosis, symptoms and physician orders and documents per chart and review standards. Documents an ... initial plan of care and completes certification . Coordinates treatment schedules with disciplines using appropriate scheduling procedures; participates with inter-disciplinary team in the development and accurate documentation of a discharge plan in the… more
- Altru Health (Crookston, MN)
- …correlates to the age of the patient, the patient's diagnosis, symptoms and physician orders and documents per chart and review standards. Coordinates treatment ... schedules with disciplines using appropriate scheduling procedures. Monitors program effectiveness and outcomes, initiating programs and development of new programs. Performs pain assessment and takes appropriate action according to standard operating… more
- Lovelace Women's Hospital (Alameda, NM)
- …the state recognized as a Center of Excellence in Robotic Surgery by Surgical Review Corporation. We believe healthcare is a team sport and every player has ... instrumentation, equipment, and sterile field setup including sterilization methods Support physician 's surgical practice in a variety of procedures including a… more
- Christus Health (Chapman Ranch, TX)
- …Duties and Responsibilities * Prepares and dispenses drug orders per physician request according to established policies, procedures, and protocols. * Interprets ... protocol. * Participates in the quality improvement and medication use review activities of the department. Collects data, conducts monitors and inspections,… more
- Christus Health (Corpus Christi, TX)
- …Duties and Responsibilities * Prepares and dispenses drug orders per physician request according to established policies, procedures and protocols. * Interprets ... protocol. * Participates in the quality improvement and medication use review activities of the department. Collects data, conducts monitors and inspections… more
- Christus Health (San Antonio, TX)
- …or Leader of Leaders. * Prepares and dispenses drug orders per physician request according to established policies, procedures, and protocols. * Interprets drug ... protocol. * Participates in the quality improvement and medication use review activities of the department. Collects data, conducts monitors and inspections,… more
- Christus Health (Youree, LA)
- …Duties and Responsibilities Prepares and dispenses drug orders per physician request according to established policies, procedures, and protocols. Interprets ... institutional protocol. Participates in the quality improvement and medication use review activities of the department. Collects data, conducts monitors and… more
- Prime Therapeutics (Columbus, OH)
- …It fuels our passion and drives every decision we make. **Job Posting Title** Physician Clinical Reviewer - GI- REMOTE **Job Description Summary** Key member of ... the utilization management team, and provides timely medical review of service requests that do not initially meet the applicable medical necessity guidelines.… more
- Evolent Health (Columbus, OH)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** As a Physician Clinical Reviewer , you will be a key member of the utilization management ... **What You Will Be Doing:** + Serve as the Physician match reviewer in Imaging cases, that...rationale for standard and expedited appeals. + Utilizes medical/clinical review guidelines and parameters to assure consistency in the… more
- Evolent Health (Columbus, OH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** As a Cardiology, Physician Clinical Reviewer you will be a key member of the utilization ... and management staff, other Physicians, and staff whenever a physician `s input is needed or required. As well as,...Will Be Doing:** + Serve as the specialty match reviewer in Cardiology cases, that do not initially meet… more
- Sharp HealthCare (San Diego, CA)
- …of the Senior Medical Director or designee for Sharp Health Plan (SHP). The Physician Reviewer will perform all reasonably necessary functions to ensure quality ... + 5 years' experience as a practicing primary care physician with knowledge of managed care and the process...of managed care and the process for prior authorization review . + California Physicians and Surgeons License - Medical… more
- Trinity Health (Athens, GA)
- …Improvement activities. To compile data and assist with maintaining Physician profiles. **II. Position Requirements** : **A: Licensure/Certification/Registration** : ... Current Georgia Registered Nursing License. **B. Education:** Graduate of an accredited school of nursing. Bachelor's degree preferred. **C: Experience:** Three to five years recent clinical experience in an acute care hospital. **D. Special Qualifications:**… more
- Kepro (AR)
- …) to join our growing team. Job Summary: The Dental Physician Reviewer -Oral Surgeon will oversee utilization review /management activities to include peer ... review , utilization review , fair hearings and appeals, and other clinical consultations...consultations related to the applicable contract. The Oral Surgeon Physician Reviewer will support the dental UM… more
- HCA Healthcare (Nashville, TN)
- …Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Clinical Reviewer with Parallon you can be a part of an organization that is ... need to succeed in our organization. We are looking for an enthusiastic Clinical Reviewer to help us reach our goals. Unlock your potential! **Job Summary and… more
- The Hartford (Alpharetta, GA)
- …necessity and appropriateness using nursing judgment, treatment criteria guidelines and Physician Advisor/Peer Clinical Review referral process. Conduct first ... Medical Reviewer - CT08BE We're determined to make a...(Hartford, CT or Alpharetta, GA) that will perform Utilization Review for Work ers' Compensation Claims. An Initial Clinical… more
- Kepro (Portland, ME)
- …for ensuring the accuracy and consistency of the Psychiatric Inpatient Concurrent Review process. This full-time Clinical Reviewer Remote position based in ... lAcentra seeks a Clinical Reviewer to join our growing team. Job Summary...must reside and work in Maine. Job Responsibilities: + Review and interpret patient records against established criteria to… more
- Elevance Health (Sacramento, CA)
- …determining whether clinical information presented meets medical necessity criteria or requires physician review or override. + Clearly and concisely documenting ... **JR132259 Genetic Counselor Reviewer ** The genetic counselor reviewer (GCR) is...clinical review and other case interactions in online database in adherence… more
- Corewell Health (Troy, MI)
- …and a focus on medical advancement. Scope of work The PI Clinical Reviewer collects, analyzes, and reports clinical data elements for the Michigan Trauma Quality ... funded Collaborative Quality Initiative (CQI). The chief responsibility of the Clinical Reviewer is to work collaboratively with the trauma program registry staff,… 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
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