• DRG Validator & Appeals Reviewer -Clinical…

    MetroHealth (Cleveland, OH)
    …improvement of capture of additional comorbid conditions. Conducts concurrent and retrospective medical record review on defined patient populations to identify ... **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **8a-430p** **The...years of CDI experience or; - CDI Second Level Reviewer with a strong understanding of disease processes, clinical… more
    MetroHealth (11/07/24)
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  • Clinical Appeals Reviewer -Utilization…

    MetroHealth (Cleveland, OH)
    **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **8a-430p** **The MetroHealth System is redefining health care by going beyond ... medical treatment to improve the foundations of community health...therapies for patients of The MetroHealth System (MHS). Analyzes medical records, reviews insurance policies, and consults with healthcare… more
    MetroHealth (11/07/24)
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  • Credit Risk Review Advisor Senior-…

    PNC (Cleveland, OH)
    …to contribute to the company's success. We are looking to hire a Credit Risk Review Advisor Senior in Credit Risk Review within PNC's Independent Risk Management ... organization. The primary objective of Credit Risk Review (CRR) is to conduct timely and independent assessments...credit exposures. You may have responsibility of being a Reviewer in Charge. The Reviewer in Charge… more
    PNC (10/12/24)
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  • Performance Assurance Analyst - Property Claims…

    Sedgwick (Cleveland, OH)
    …revisions as required via Xactimate and/or Symbility as appropriate. + Documents review findings in accordance with team processes. + Identifies and provides ... the Team Lead to contribute to the performance management review meetings and group training, as needed. + Maintains...years at an advanced technical level as a file reviewer of personal and commercial claims, or equivalent combination… more
    Sedgwick (08/30/24)
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  • Clinical Research Charge Review Analyst

    MetroHealth (Cleveland, OH)
    **Location:** **METROHEALTH MEDICAL CENTER** **Biweekly Hours:** **80.00** **Shift:** **8-4:30** **The MetroHealth System is redefining health care by going beyond ... medical treatment to improve the foundations of community health...direct involvement with sponsored clinical trials. Experience with electronic medical record (EMR) systems. Experience within a healthcare provider… more
    MetroHealth (09/20/24)
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  • Senior Technical Lead/Project Manager - CCR…

    AECOM (Cleveland, OH)
    …activities. + Mentor and coach team members as required + Serve as a reviewer + Local and national travel (up to 20% of the time). **Qualifications** **Required ... of our employees. Depending on your employment status, AECOM benefits may include medical , dental, vision, life, AD&D, disability benefits, paid time off, leaves of… more
    AECOM (09/27/24)
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  • Senior Project Manager

    Terracon (Parma, OH)
    …client. Coordinates effort and effectively works with the Authorized Project Reviewer (APR) throughout the project, particularly at critical junctures. Is involved ... Based on eligibility, role and job status, we offer many programs including medical , dental, vision, life insurance, 401(k) plan, paid time off and holidays,… more
    Terracon (09/11/24)
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  • Proposal Writer

    Elevance Health (Independence, OH)
    …written solutions, leveraging best practices, brand standards, innovative ideas, and reviewer insights. + Identifies and creates standard content for the proposal ... and incentive bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits, 401(k) +match,… more
    Elevance Health (11/08/24)
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  • Medical Policy Consultant (US)

    Elevance Health (Independence, OH)
    ** Medical Policy Consultant** National Government Services is a proud member of Elevance Health Companies, Inc. family of brands. We administer government contracts ... - Friday 8 am - 4:30 pm EST.** The ** Medical Policy Consultant** is responsible for researching and drafting...modifies policies using consistent template tools and criteria. + Review new and updated codes for accuracy and consistency.… more
    Elevance Health (11/07/24)
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  • Nurse Practitioner (Acute Care), Physician…

    Cleveland Clinic (Cleveland, OH)
    …Nurse Practitioner (Acute Care Certified) for a full time Intensivist position in Medical and Cardiac ICUs at Fairview, Hillcrest, and Main Campus. The position ... licensed healthcare provider who provides primary and/or specialty nursing and/or medical care in a variety of healthcare settings. Functions in collaboration… more
    Cleveland Clinic (08/31/24)
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  • Nurse Practitioner (Adult or Acute Care),…

    Cleveland Clinic (Independence, OH)
    …licensed healthcare provider who provides primary and/or specialty nursing and/or medical care in a variety of healthcare settings. Functions in collaboration ... licensed healthcare provider who provides primary and or specialty medical care (the practice of medicine) in a variety...data analysis. + Participates in quality monitoring thru the review of records and treatment plans for patient outcomes… more
    Cleveland Clinic (11/05/24)
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  • Nurse Practitioner, Physician Assistant…

    Cleveland Clinic (Independence, OH)
    …Care is looking to add a Physician Assistant or Nurse Practitioner to our Medical Care at Home Urgent Dispatch APP Team. Urgent Dispatch provides in-home evaluation ... this role include but are not limited to in-home medical visits, lab draws, Point-of-Care Lab testing, foley catheter...as necessary. + Participates in quality monitoring thru the review of records and treatment plans for patient outcomes… more
    Cleveland Clinic (08/29/24)
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  • Graphic Designer

    Medical Mutual of Ohio (Brooklyn, OH)
    …work at home as long as you reside within a 50-mile radius of the Brooklyn, OH Medical Mutual office._** Founded in 1934, Medical Mutual is the oldest and one of ... well as Medicare Advantage, Medicare Supplement and individual plans. Medical Mutual' s status as a mutual company means...designers. . Meets with line of business personnel to review project scope and goals. . Presents design concepts… more
    Medical Mutual of Ohio (10/30/24)
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  • Emergency General Surgery Medical Director,…

    Cleveland Clinic (Cleveland, OH)
    **Emergency General Surgery Medical Director, Cleveland Clinic Hillcrest Hospital** Job Profile Summary: The Emergency General Surgery Medical Director (EGS MD) ... us or care for patients with EGS conditions. + Review /develop care pathways in collaboration with nursing management teams....eligible/able for trauma call. + Eligible to obtain a medical license to practice medicine in the state of… more
    Cleveland Clinic (10/18/24)
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  • Medical Case Manager - Part Time

    Crawford & Company (Cleveland, OH)
    …effective case management services in an appropriate, cost effective manner. Provides medical case management service which is consistent with URAC standards and ... records and reports, collects and analyzes data, evaluates injured worker/disabled individual's medical status, identifies needs and obstacles to medical case… more
    Crawford & Company (08/13/24)
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  • Dynamics CRM Architect I-III

    Medical Mutual of Ohio (Brooklyn, OH)
    Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million ... including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Medical Mutual' s status as a mutual company means we are owned by our… more
    Medical Mutual of Ohio (10/05/24)
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  • Medical Director of Microbiology

    Cleveland Clinic (Cleveland, OH)
    ** Medical Director of Microbiology CLEVELAND CLINIC** The Cleveland Clinic is recruiting a "Patients First" academic clinical pathologist or doctoral-level clinical ... join the Professional Staff of Cleveland Clinic as a Medical Director of Microbiology. The Section of Microbiology is...Any application submitted without a CV will delay the review process Please be advised that all information entered… more
    Cleveland Clinic (11/09/24)
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  • Medical Support Assistant (Advanced)

    Veterans Affairs, Veterans Health Administration (Cleveland, OH)
    Summary The VA Northeast Ohio Healthcare System is recruiting for Medical Support Assistants (Advanced). The Medical Support Assistant (Advanced) will function ... to: Schedules patient appointments. Coordinates with the patient care team to review the clinic utilization by using various reports (eg, Clinic Utilization… more
    Veterans Affairs, Veterans Health Administration (11/01/24)
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  • Clinical Health Psychologist: Hepatology and Liver…

    Cleveland Clinic (Cleveland, OH)
    **Clinical Health Psychologist: Hepatology and Liver Disease Medical Home** The Cleveland Clinic Digestive Disease Institute and Neurological Institute are ... new model of care: The Hepatology and Liver Disease Medical Home. Cleveland Clinic is a World Class academic...Any application submitted without a CV will delay the review process Please be advised that all information entered… more
    Cleveland Clinic (09/17/24)
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  • PM&R Medical Director

    Cleveland Clinic (Cleveland, OH)
    ** Medical Director for Beachwood Inpatient Rehabilitation Facility** We are seeking a mid-career physiatrist with leadership experience to serve as Medical ... a joint venture partnership between Cleveland Clinic and Select Medical , has been consistently recognized as one of the...Any application submitted without a CV will delay the review process Please be advised that all information entered… more
    Cleveland Clinic (08/17/24)
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