- Magellan Health Services (Johnstown, PA)
- …supervision. Project management skills and demonstrated experience. General Job Information Title Quality Clinical Reviewer , Licensed /Remote in PA ... reporting. Interacts with multiple stakeholders internally and externally. Provides clinical reviews of Quality of Care (QOC)... Psychology License and Certifications - Required LCSW - Licensed Clinical Social Worker - Care Mgmt,… more
- The Cigna Group (Bloomfield, CT)
- …to Care Managers, Clinical Managers, Providers and other Peer Reviewers in clinical quality improvement process. + Acts as behavioral health consultant in ... Performs peer review and case management activities. Delivers clinical expertise to the organization through peer review , decision making, training,… more
- Magellan Health Services (Baton Rouge, LA)
- …other clinical staff. + Provides training, interpretation and support for QI Clinical Reviewer staff. + Audits and validates internal audit results and/or ... according to medical necessity criteria. General Job Information Title Clinical Reviewer III (Baton Rouge, LA or...- Preferred License and Certifications - Required LCSW - Licensed Clinical Social Worker - Care Mgmt,… more
- Kepro (AR)
- …Preferred Qualifications/Experience: + Utilization Review /Utilization Management experience. + Clinical quality review experience with medical records. ... vital partner for health solutions in the public sector. Acentra is looking for a Clinical Reviewer - Behavioral Health - PRN (Remote within Arkansas) ** The… more
- Trinity Health (Livonia, MI)
- …Collaborative Quality Initiative (CQI). This is accomplished through high- quality clinical screening, data compilation, documentation, and entry into ... with the physician champion and appropriate hospital leadership to identify opportunities for clinical quality improvement and other special projects as may be… more
- Pfizer (Collegeville, PA)
- The Clinical Data Reviewer (CDR) is highly specialized to perform clinical data review , most often in a submission timeline. The studies supported by the ... RESPONSIBILITIES + The CDR is routinely responsible for the clinical data review of one or more...with applicable training requirements, constantly seeking further improvements in quality and efficiency of clinical procedures. +… more
- SSM Health (MO)
- …(CDI) specialist is responsible for facilitating the improvement in the overall quality and completeness of provider-based clinical documentation in the medical ... as well as the level of services rendered. The CDI Specialist assesses clinical documentation through extensive review of the medical record, interaction with… more
- Centers Plan for Healthy Living (Garden City, NY)
- HEDIS Reviewer 990 Stewart Ave, Garden City, NY 11530, USA Req #879 Tuesday, November 5, 2024 Centers Plan for Healthy Living's goal is to create the ultimate ... and plans they need for healthy living. JOB SUMMARY: The HEDIS Reviewer is responsible for supporting the overall direction, coordination and implementation of… more
- ManpowerGroup (Columbia, SC)
- **Title: Medical Reviewer ** **Location:** **4101 Percival Road Columbia SC 29229 US (Onsite)** **Duration: 03+ Month's Contract** **Shift: Monday to Friday, 8 AM - 5 ... $20.00 to $23.00/hr.** We are looking for a "Medical Reviewer " to join one of our Fortune 500 clients....of our Fortune 500 clients. **Job Summary** The Medical Review and Utilization Management Specialist is responsible for performing… more
- ManpowerGroup (Columbia, SC)
- **Job Title: Medical Claims Reviewer ** **Pay Rate:23/Hr (REMOTE opportunity after training)** **Duration:3+ Months on W2** **Location:4101 Percival Road Columbia SC ... license as defined by the Nurse Licensure Compact (NLC), OR, active, unrestricted LBSW ( Licensed Bachelor of Social Work) licensure from the United States and in the… more
- Kepro (AR)
- …management experience. + Experience with State Medicaid Dental programs. + Utilization Management/ Clinical Review experience. #LI-SD1 Why us? We are a team ... the Clinical Director and Medical Director, the Supervisor, Dental Review oversees dental staff performing Utilization Management (UM) Reviews for Medicaid… more
- Centene Corporation (Baton Rouge, LA)
- …management, utilization management, or quality improvement. **License/Certification:** LCSW - Licensed Clinical Social Worker required or LMHC- Licensed ... on workplace flexibility. Outpatient Behavioral Health experience AND a Licensed Clinician (LCSW, LMHC, LPC, or LMFT) with a...the Operations and Medical Management teams. Assesses and performs review of member clinical records and services… more
- Lucile Packard Children's Hospital Stanford (Sunnyvale, CA)
- …This paragraph summarizes the general nature, level and purpose of the job. Licensed Clinical Social Worker is the second and fully-qualified, full-proficiency ... licensed by the State of California as Licensed Clinical Social Workers (LCSW). Positions at...education and training, communication and adherence to safety and quality programs, sustaining compliance with National Patient Safety Goals,… more
- The Arora Group (Fort Belvoir, VA)
- Licensed Clinical Social Worker Allied / Privileged Currently recruiting a Licensed Clinical Social Worker to provide care to active duty military ... members and their families at Ft. Belvoir, Virginia. The Licensed Clinical Social Worker is a full-time...records IAW AR40-66. Medical records will be subject to review by the Medical Care Evaluation Committee, Quality… more
- Centene Corporation (Raleigh, NC)
- …management, utilization management, or quality improvement. **License/Certification:** LCSW - Licensed Clinical Social Worker required or LMHC- Licensed ... information from the Operations and Medical Management teams. Assesses and performs review of member clinical records and services related to behavioral health… more
- HCA Healthcare (San Antonio, TX)
- …opportunity compelling, we encourage you to apply for our Licensed Clinical Manager opening. We promptly review all applications. Highly qualified candidates ... diversity and inclusion thrive? Submit your application for our Licensed Clinical Manager opening with HCA Healthcare...that we continue to provide all patients with high quality , efficient care. Did you get into our industry… more
- All About Kids (Yonkers, NY)
- …well as fully licensed Speech Language Pathologists (SLP). Our ASHA certified, state- licensed clinical fellow supervision team will work with you on your ... needed anytime + Work with a dedicated ASHA certified, state- licensed clinical fellow supervisor who will support...looking for ways to improve and deliver the highest quality therapy service Compensation For Clinical Fellows:… more
- Western Sierra Medical Clinic Inc (Kings Beach, CA)
- …scheduling are also available. WSMC will work with you! JOB TITLE: Licensed Clinical Social Worker REPORTS TO: Behavioral Health Director/Chief Operations ... Officer GENERAL STATEMENT OF DUTIES: The licensed clinical social worker is responsible for...appropriate. * Participate in staff meeting and the Total Quality Management Program of the Clinic. * Ensure adequate… more
- Morehouse School Of Medicine (Atlanta, GA)
- Associate or Assistant Professor ( Licensed Clinical Social Worker (LCSW) Bookmark this Posting Print Preview | Apply for this Job Posting Details Position ... Posting Number ACAD469 Job Title Associate or Assistant Professor ( Licensed Clinical Social Worker (LCSW) Position Title...members to develop and implement behavioral health plan Maintain quality care and participate in peer review ,… more
- KBR (Colorado Springs, CO)
- Title: Special Operations Licensed Clinical Social Worker (10th SFG, Ft. Carson CO) THIS POSITION OFFERS RELOCATION. Belong. Connect. Grow. with KBR! KBR is a ... and astronauts. We are looking for a Special Operations Licensed Clinical Social Worker to join the...treatment evaluations. Essential Duties & Responsibilities: + Engage all quality improvement and staff meetings , conferences + Conduct… more