- Molina Healthcare (Spokane, WA)
- …Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years of experience in ... clinical/ medical reviews of retrospective medical claim reviews, medical claims and...Claims Auditing, Medical Necessity Review and Coding experience +… more
- Molina Healthcare (Spokane, WA)
- … claims with corresponding medical records to determine accuracy of claims payments. + Review of applicable policies, CPT guidelines, and provider ... policies, CPT guidelines, internal policies, and contract requirements. This position completes a medical review to facilitate a referral to law enforcement or… more
- Molina Healthcare (Spokane, WA)
- …retrospective reviews of claims and appeals and resolves grievances related to medical quality of care. + Attends or chairs committees as required such as ... Medical Officer. + Evaluates authorization requests in timely support of nurse reviewers; reviews cases requiring concurrent review , and manages the denial… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …care of the dermatology patient. Help supervise and train physician assistants, nurse practitioners, residents, and medical student trainees. Perform the ... available staffing, which includes physicians, consultant and attendings, physician assistants/ nurse practitioners, residents, and students. Responsibilities Duties include but… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- Summary The incumbent serves as Section Chief for Psychiatric Services and Medical Director for the Behavioral Health Service (BHS) at VAMC Spokane. In this role, ... Chief of Behavioral Health Service in all matters related to psychiatric and medical care. Responsibilities Duties include but are not limited to: Providing clinical… more
- Veterans Affairs, Veterans Health Administration (Spokane, WA)
- …are not limited to: Coordinating and providing clinical oversight of physicians, nurse practitioners, and other professionals who provide or support provision of ... of all supervisees. Promoting clinical training and development of acute and specialty medical staff and those who support provision of psychiatric care. Assisting … more