- St. Luke's Health System (Boise, ID)
- …aspects of the department, including organizing and conducting programs and establishing procedures for medical staff peer review functions across the ... health system. + Liaison and resource for medical staff peer review committees and the committee chairs across the St. Luke's Health System for peer … more
- Teradata (Boise, ID)
- …+ Familiarity with software configuration management tools, defect tracking tools, & peer review tools + Excellent debugging skills to troubleshoot and ... national origin, sexual orientation, age, citizenship, marital status, disability, medical condition, genetic information, gender identity or expression, military… more
- Trinity Health (Boise, ID)
- …programs are compliant with legal and regulatory requirements. B. Participates in peer review activities as requested. C. Identifies human resource, compliance ... and maintain positive rapport with dyad partner, SAHS leadership, peers, physicians and staff . 5. Ability to work with Trinity Health experts in managing and… more
- Evolent (Boise, ID)
- …when available, within the regulatory timeframe of the request. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... rationale for standard and expedited appeals. + Discusses determinations ( peer to peer phone calls) with requesting...(NCQA) guidelines. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Evolent (Boise, ID)
- …and provides clinical rationale for standard and expedited appeals. + Utilizes medical /clinical review guidelines and parameters to assure consistency in the ... completed by the subject matter expert. + Discusses determinations ( peer to peer phone calls) with requesting...Clinical Reviewers. + Ensures documentation of all communications with medical office staff and/or MD provider is… more
- Highmark Health (Boise, ID)
- …**ESSENTIAL RESPONSIBILITIES:** + Risk Analysis of New and Pre-Screen opportunities + Applies medical review and medical underwriting principles to all New ... Highmark's mission to provide and maintain affordable products, by performing ongoing review of the medical underwriting guidelines and departmental procedures.… more
- Merck (Boise, ID)
- **Job Description** **Role Summary** + The Regional Medical Scientific Director (RMSD) is a credentialed (ie, PhD, PharmD, DNP, MD) therapeutic and disease expert ... who engages in bidirectional exchange of scientific or medical information with Scientific Leaders (SLs). The role provides balanced, factual, scientific information… more
- Molina Healthcare (Nampa, ID)
- …**R** **RED E** **X** **PE** **R** **I** **E** **N** **C** **E:** + Peer Review , medical policy/procedure development, provider contracting experience. + ... Summary** Responsible for serving as the primary liaison between administration and medical staff . Assures the ongoing development and implementation of policies… more
- R1 RCM (Boise, ID)
- …client facilities navigate the path to compliant revenue by reviewing payor peer -to- peer cases. Every day you will review cases for which authorization has ... clinical evaluation of the request as a whole. + Review and respond to the payor and customer in...multiple specialties. + Serve as a clinical resource to medical and case management staff by providing… more
- Trinity Health (Boise, ID)
- …remedial actions. Reassign events to appropriate department/clinic leadership and/or to peer review . Ascertain clinical course of patient from documentation ... trend analyses. Prepares or provides materials for reports for applicable committees, the medical staff , and the governing board. Participates in hospital or … more
- Humana (Boise, ID)
- …and mitigating enterprise risks + Provide administrative and operational guidance to analyst staff , supports initial and continuous training for analyst staff + ... and regular reporting to HSS and senior leadership + Continuously review and maintain intelligence requirements, incident recognition, crisis response, team internal… more
- St. Luke's Health System (Boise, ID)
- …quality, patient safety, accreditation, infection prevention, radiation safety, performance improvement and peer review . + Responsible for the quality and safety ... between the system and operating units and across the medical staffs. + Lead High Reliability and Safety Together...Quality and Safety Officer. + Serve as a supporting staff role to the Quality, Safety, and Service Excellence… more
- Cardinal Health (Boise, ID)
- …operations and supervises professional employees, frontline supervisors and/or business support staff + Participates in the development of policies and procedures to ... work processes, outcomes, and customers + Interacts with subordinates, peer customers and suppliers at various management levels may...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Cardinal Health (Boise, ID)
- …operations and customers + Frequently interacts with subordinates, customers, and peer groups at various management levels + Interactions normally involve ... **_Responsibilities_** The Customer Service Operations Supervisor will oversee program staff performing customer service, enrollment and reimbursement activities, benefit… more
- Cardinal Health (Boise, ID)
- …operations and supervises professional employees, frontline supervisors and/or business support staff + Participates in the development of policies and procedures to ... work processes, outcomes, and customers + Interacts with subordinates, peer customers and suppliers at various management levels may...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more
- Highmark Health (Boise, ID)
- …Active participation in on-going interdisciplinary communication specific to each patient with review of patient status and plan of care. + Directing and organizing ... + Adherence to Allegheny Health Network policies and procedures regarding medical record documentation and Performance Improvement activity. + Home Infusion visits… more
- Noblis (Boise, ID)
- …computational advantage. Example research problems include: + Follow, understand and review the technological developments in the sector of quantum computing, and ... of experience **Desired Qualifications** + Experienced in publishing related work in peer reviewed journals, and contributing to obtaining new funding in the areas… more
- Cardinal Health (Boise, ID)
- …operations and supervises professional employees, frontline supervisors and/or business support staff . + Participates in the development of policies and procedures ... work processes, outcomes, and customers. + Interacts with subordinates, peer customers and suppliers at various management levels may...benefits and programs to support health and well-being. + Medical , dental and vision coverage + Paid time off… more