Utilization Review Clinician

HireOps Staffing LLC is seeking a highly skilled Utilization Review Medical Professional to join our team in Texas for a 6-month contract. This remote position involves assessing medical necessity and appropriateness of treatment plans using medically accepted criteria in the insurance or managed care industry.Job Description:The successful candidate will be...

Job OverviewCorroHealth is a leading provider of healthcare solutions, dedicated to helping clients achieve financial health goals. We seek an experienced Clinical Expert in Healthcare Compliance and Utilization Review to join our team.About the RoleThis critical position involves evaluating hospitalizations across the country, utilizing clinical knowledge...

We are seeking an Orthopedic Reviewer to join our team at Dane Street, LLC in the Dallas or Houston area. As a Physician Reviewer, you will play a crucial role in analyzing medical records and applying CPT codes to ensure accurate determinations.Our company offers a competitive salary of $120,000 - $180,000 per year, depending on experience. We also provide...

Job SummaryRelying on your clinical background, you will review health claims, providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals. You will be working in compliance with Concentra Physician Review policies, procedures, and performance standards as well as URAAC guidelines and state...

Job Title: Medical Review SpecialistEstimated Salary:$120,000 - $150,000 per yearThe University of Texas Southwestern Medical Center is seeking a highly skilled Medical Review Specialist to join our team. As a key member of our healthcare quality assurance team, you will be responsible for conducting medical necessity reviews and ensuring that patients...

HireOps Staffing LLC is seeking a skilled Clinical Review Nurse to join our team. This contract position offers a competitive salary of $40/hour, commensurate with experience.The successful candidate will possess 3 years of clinical experience in a physician office, hospital/surgical setting, or healthcare insurance company. Key skills include medical...

Job Summary:We are seeking a skilled Clinical Review Specialist to join our team at Elite PC Services. As a key member of our utilization review team, you will be responsible for evaluating medical necessity and determining the appropriateness of treatments in Workers' Compensation cases.About the Role:Evaluate medical data and treatment requests to...

Job Title:We are seeking a skilled Workers Compensation Utilization Manager to join our team at Elite PC Services. As a Clinical Review Specialist, you will be responsible for managing the utilization review process and ensuring compliance with industry standards.About the Role:Manage the utilization review process from intake to resolution.Ensure compliance...

Job Description: Workers Compensation Utilization AnalystWe are seeking a detail-oriented Workers Compensation Utilization Analyst to join our team at Elite. In this role, you will be responsible for reviewing medical data to ensure the medical necessity of treatments for our Workers Compensation clients.Key Responsibilities:Evaluate medical data for...

Medical Lead for Utilization ManagementParkland Health & Hospital System is seeking a Medical Lead for Utilization Management to join our team. In this role, you will be responsible for reviewing requests for prior authorization and appeals, as well as performing peer-to-peer calls to support our utilization management process.You will work closely with our...

We are looking for a highly skilled Healthcare Utilization Specialist to join our team at Elite. In this vital role, you will play a critical part in our utilization review process, applying evidence-based guidelines to evaluate medical necessity and make informed decisions regarding treatment requests.You will work closely with healthcare providers,...

Job OverviewThe Bill Review Manager III at CorVel plays a pivotal role in the overall operation of designated bill review offices. As a key member of our team, you will participate in formulating and administering company best practices while developing long-range goals and objectives. This position requires analyzing costs, activities, and operations to...

Estimated Salary: $75,000 - $95,000 per year">Join Our Team as a Utility Line Clearance SupervisorWe are a dynamic company looking for an experienced leader to oversee our utility line clearance division. As a Utility Line Clearance Supervisor, you will be responsible for managing a team of forepersons and assisting general forepersons to deliver exceptional...

At UT Southwestern Medical Center, we are expanding our team of mental health clinicians in the Department of Psychiatry. This research-focused position provides treatment in major depressive disorder, bipolar disorder, and anxiety and trauma-related disorders. Our schedule is Monday-Friday, 8:00 a.m.-5:00 p.m., offering a stable work-life...

McGough Construction is committed to excellence in our high-profile projects. Our employee tenure reflects the commitment and pride we share in our work.About the PositionThe Associate General Counsel role involves advising internal teams on legal and risk-related matters. The ideal candidate will have strong business judgment, problem-solving capabilities,...

ResponsibilitiesPrepare detailed labor and material cost estimates, ensuring accuracy and efficiency.Collaborate closely with project management to coordinate efforts effectively.Develop bills of material and other necessary information for purchasing teams.Evaluate constructability requirements through field walk-downs with customers, subcontractors, and...

About UsMcKim & Creed, Inc. is a top-ranked engineering and geomatics firm with a strong presence in the US. We pride ourselves on our commitment to delivering exceptional solutions and creating a positive impact in our communities.As a key player in the industry, we recognize the importance of innovation, teamwork, and customer satisfaction. Our goal is to...

Medical Billing Analyst PositionEstimated Salary: $50,000 - $70,000 per yearBaylor Scott & White Healthcare is seeking a detail-oriented and analytical Medical Billing Analyst to join our team. As a key member of our revenue cycle team, you will be responsible for reviewing and processing medical claims to ensure accurate reimbursement.About the Role:Review...

Leadership Opportunity in Ambulatory Surgical ServicesSurgery Partners is seeking a seasoned executive to lead our ambulatory surgical services team.Company OverviewAs the largest and fastest-growing surgical services company, we are dedicated to delivering exceptional patient care and experiences. Our organization is comprised of over 180 locations across...

Job Description SummaryWe are seeking an experienced Regional Sales Manager to lead our team of Clinical Area Managers in the South Central region. The successful candidate will be responsible for achieving Revenue and Referral targets, providing leadership, focus, coaching, and inspection to the execution of strategic corporate initiatives. Key...