- Kepro (AR)
- …complicated Utilization Management reviews or clinical scenarios with Utilization Management Dental Hygienist Reviewers . + Participate in the client's quarterly ... being a vital partner for health solutions in the public sector. The Dental Physician Reviewer will oversee utilization /management (UM) activities to include peer… more
- Kepro (AR)
- …for Arkansas Medicaid. Job Responsibilities: + Collaborate with Medical Director and other Dental Physician Reviewers on case consultations as needed. + Discuss ... complicated Utilization Management reviews or clinical scenarios with Utilization Management Dental Hygienist Reviewers . + Review safety, sentinel, and Quality… more
- City of Tacoma WA (Tacoma, WA)
- …and timelines. + Serves as a liaison between review engineers, plan reviewers , land use planners, inspectors and external developers/applicants while providing high ... as needed. + Coordinates and facilitates meetings between customers and reviewers including pre-development meetings where applicants can receive clarification on… more
- Corner Alliance (Washington, DC)
- …create results for the government. We are currently seeking multiple Programmatic Application Reviewers with 4+ years of experience to join our team and fully ... with expected deliverables of data entry, completed checklists, and draft communications. Reviewers shall be available to conduct reviews beginning November 4, 2024… more
- Elevance Health (Norfolk, VA)
- …and providers for care-coordination. + May access and consult with peer clinical reviewers , Medical Directors and/or delegated clinical reviewers to help ensure ... healthcare providers. + Refers treatment plans/plan of care to peer clinical reviewers in accordance with established criteria/guidelines and does not issue medical… more
- Elevance Health (Latham, NY)
- …providers for care coordination. + May access and consult with peer clinical reviewers , Medical Directors and/or delegated clinical reviewers to help ensure ... healthcare providers. + Refers treatment plans/plan of care to peer clinical reviewers in accordance with established criteria/guidelines and does not issue medical… more
- Elevance Health (Tampa, FL)
- …and providers for care-coordination. + May access and consult with peer clinical reviewers , Medical Directors and/or delegated clinical reviewers to help ensure ... healthcare providers. + Refers treatment plans/plan of care to peer clinical reviewers in accordance with established criteria/guidelines and does not issue medical… more
- Citigroup (Wilmington, DE)
- …aspects of the Exam and Audit spectrum of work including: working with reviewers on scope and focus, preparing deliverables and meetings, leveraging prior existing ... business, mediating discussions during the review, providing guidance to business SMEs and reviewers and helping to ensure a proper result and conclusion to every… more
- Citigroup (Irving, TX)
- …activities, including establishing key risk indicators (KRI) to facilitate Lead Reviewers execute BM coverage of relevant credit risk families. Develop customized ... analytics for Risk Differentiated Reviews (RDR), which help reviewers in determining key focus areas for the detailed review plan, and in detecting potential… more
- Parsons Corporation (Washington, DC)
- …through established work flow for review/approval to the pertinent AOC staff, reviewers and consultants and transmits responses back to contractors for action. The ... and responses issued by AOC and its consultants and reviewers . Services will be performed on-site and the CMS...is why we offer best-in-class benefits such as medical, dental , vision, paid time off, Employee Stock Ownership Plan… more
- Medical Mutual of Ohio (OH)
- …to more than 1.2 million members through our high-quality health, life, disability, dental , vision and indemnity plans. We offer fully insured and self-funded group ... updates, procedure changes, etc.** + **Discusses consult findings with Physician Reviewers and reviews edit updates and questions with payment recovery staff.**… more
- Cardinal Health (Columbus, OH)
- …to original agreement and prior amendments + Determine appropriate 2nd line reviewers /approvers. Route to appropriate team members and Account Executive aligned to ... Monitor & track edits and approvals as received from reviewers + Consolidate redlines/comments, review/work with AE, and upon...and programs to support health and well-being._ + _Medical, dental and vision coverage_ + _Paid time off plan_… more
- University of Pennsylvania (Philadelphia, PA)
- …in selecting and vetting new projects. + Assisting the editors in seeking peer reviewers ; managing the processes of sending manuscript to peer reviewers and ... Flexible Spending Accounts : Penn offers comprehensive medical, prescription, behavioral health, dental , vision, and life insurance benefits to protect you and your… more
- Koniag Government Services (Germantown, MD)
- …offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending ... time off, and more. Koniag Government Services is seeking experienced Lead Document Reviewers Level 5 (DRL5) to join a dynamic team supporting critical government… more
- ADM (Mankato, MN)
- …with OJT (on the job training) mentors, subject matter experts, procedure reviewers , training reviewers , engineers, managers/supervisors, and EHS staff to ... package to enhance your well-being, including: + **Physical wellness** - medical/Rx, dental , vision and on-site wellness center access or gym reimbursement (as… more
- HCA Healthcare (North Richland Hills, TX)
- …services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, ... and communicates with a variety of clinical disciplines and/or physician reviewers to clarify/justify the variation. + Recognizes variations from criteria and… more
- Elevance Health (Jacksonville, FL)
- …and member eligibility, benefits, and contracts. + Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost ... the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications. + Facilitates accreditation… more
- Elevance Health (Mason, OH)
- …a cost effective setting according to contract. + Consults with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost ... the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications. + Facilitates accreditation… more
- Elevance Health (Los Angeles, CA)
- …a cost effective setting according to contract. + Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost ... the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications. + Facilitates accreditation… more
- Elevance Health (Atlanta, GA)
- …a cost effective setting according to contract + Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost ... the healthcare continuum and refers treatment plans/plan of care to clinical reviewers as required and does not issue non-certifications. + Facilitates accreditation… more