Utilization Management Nurse Reviewer

Dane Street, a certified "Great Place to Work" company, is seeking a Physician to provide utilization review services for the Group Health Department.This role requires utilizing clinical expertise to review medical records and provide an interpretation of the medical appropriateness of services in compliance with state regulations, nationally recognized...

Job Summary:We are seeking a Board Certified Internal Medicine physician to join our medical review team as a telecommute medical review specialist. This is a contract position that offers a flexible schedule and the opportunity to work from home.Responsibilities:Reviews medical files and provides recommendations for utilization review, chart reviews,...

Job SummaryRelying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations.ResponsibilitiesReviews...

Job SummaryVIVIO Health is seeking a highly skilled Therapy Plan Reviewer to join our dynamic team. As a key member of the Therapy Planning Team, you will play a pivotal role in ensuring evidence-based and cost-effective therapy drug management.Key Responsibilities:Review therapy requests pursuant to VIVIO's processes and policiesProvide collaborative...

Job SummaryMedReview LLC is seeking a highly motivated and experienced registered nurse to join our Hospital Bill Review Department. As a Clinical Auditor, you will be responsible for performing bill reviews and chart validations to ensure accuracy and accountability in healthcare. Key ResponsibilitiesConduct thorough reviews of medical records to identify...

Job Summary:US Tech Solutions is seeking a skilled Clinical Nurse Consultant to join our team. As a Clinical Nurse Consultant, you will be responsible for reviewing and evaluating clinical information and documentation to ensure compliance with regulatory and accreditation guidelines.Key Responsibilities:Review and evaluate clinical information and...

About Children's Hospitals and Clinics of MinnesotaAs a leading pediatric health system in the United States, Children's Hospitals and Clinics of Minnesota is dedicated to providing exceptional care to children from birth through young adulthood.Our organization is committed to excellence in patient care, education, and research, and we are proud to be...

The Senior Account Manager at AssistRx cultivates and maintains relationships with pharmaceutical manufacturing partners. This role involves working with pharmaceutical executives to ensure they receive maximum value from iAssist's features and services. The Account Manager presents new ideas and innovations to clients, upselling and enhancing their products...

Account Director / Sr. Account ManagerThe Moran Group is seeking a seasoned professional to lead the marketing strategy of a group of clients. This role involves coordinating execution with the internal agency team and providing top-notch customer service to clients.Key Responsibilities:Develop strategic recommendations for assigned clients with the help of...

Job Title: Case Manager RNAt CVS Health, we're committed to delivering exceptional healthcare services that prioritize our patients' needs. As a Case Manager RN, you'll play a vital role in ensuring our members receive comprehensive care that addresses their unique health challenges.Job Summary:This is a remote Case Manager RN position with the Costco Team,...

About Children's Hospitals and Clinics of MinnesotaWe are a pediatric health system in the United States, providing care exclusively to children from birth through young adulthood.Our organization is an independent and not-for-profit system since 1924, serving kids throughout the Upper Midwest at two free-standing hospitals, nine primary care clinics,...

Job Title: Senior Manager of Repair Field OperationsAt Otis, we are seeking a highly motivated and experienced Senior Manager of Repair Field Operations to lead our team in the Northwest sub-region. As a key member of our leadership team, you will be responsible for driving field efficiency and quality improvements, achieving annual sales and margin plans,...

Job Title: Technical Services ManagerThe Technical Services Manager is a key leadership role accountable for overseeing the coordination of biomedical technical and facility services across multiple dialysis clinics. This position requires extensive expertise and a high degree of judgment to effectively address challenges within the context of established...

Job Title: Tax ManagerJob Summary: We are seeking a highly skilled Tax Manager to join our team at Navigator Recruiting. As a Tax Manager, you will be responsible for reviewing business tax returns and overseeing business accounting. You will also prepare moderately complex business tax returns and have the opportunity to work on special projects, business...

Job SummaryLogistics Management Institute is seeking a skilled Software Development Engineer in Test to support the development of the Army Training Information System. The ideal candidate will have experience with test automation frameworks, web-based applications, and Agile software development methodologies.Key ResponsibilitiesDesign and develop test...

Job Overview: As a key member of our team at Search Solution Group, you will play a vital role in driving revenue and profit growth for our client by generating and maintaining strong customer relationships and identifying new business opportunities within the territory. This remote position, based in the Atlanta, GA area, requires frequent travel to Canada...

About the Role:We are seeking a highly motivated and experienced Repair Field Operations Leader to provide direction, support, and leadership for our Billable Repair business in the Northwest Operating Area.Key Responsibilities:Drive field efficiency and quality improvements to meet labor and material margin plans.Achieve annual sales and margin plans for...

Job TitleMergers and Acquisitions Manager - Healthcare SectorJob SummaryRemX is seeking a skilled Mergers and Acquisitions Manager to lead strategic growth initiatives in the healthcare sector. The ideal candidate will possess extensive experience in transaction management and will be responsible for leading various M&A initiatives from inception to...

Job OverviewEnterprise Engineering seeks a skilled UM Nurse to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure members receive the services and resources required to meet...

Job Title: Sr. Energy Programs Manager, CAISOStem US Operations Inc. is seeking a highly skilled and experienced Sr. Energy Programs Manager to join our team in San Francisco, CA. As a key member of our Grid Services Program Management team, you will be responsible for building, executing, and measuring the performance of our market operations in North...