’ Compensation Utilization Management Standards and Policy and Procedures Comply with URAC Standards and Policy and Procedures...Medical Reviewer - CT08BE We’re determined to make a difference and are proud to be an insurance company that goes...
or hospital setting or minimum of 1 year of prior utilization management, medical management and/or quality management...: Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PPO and POS...
setting or minimum of 1 year of prior utilization management, medical management and/or quality management, and/or call center... with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed health care including HMO, PO and POS plans strongly...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a Nurse Reviewer (RN... the need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines as defined...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a Nurse Reviewer (RN... the need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines as defined...
Job Description: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical... expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide...
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the...
/utilization management/prior authorization matters. Ensure staff supporting project/contract activities have the tools.../utilization management/prior authorization matters Ensure staff supporting project/contract activities have the tools...
Job Description: As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical... expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide...
As Physician Reviewer/Advisor for Independent Medical Exams (IME), you will utilize clinical expertise and reviews... insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a Nurse Reviewer... need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines as defined...
balance, continuous learning, and career development. Summary We are seeking a talented individual for a Nurse Reviewer... need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines as defined...
Seeking a Board-Certified Physician to serve as an Onsite Physician Advisor supporting Care Management and Clinical...: Utilization Management (20%) Lead the Utilization Review Committee in collaboration with the Care Management Director Perform...
carrier or legal counsel. Peer Reviewer / Physician Advisor Review medical records: Evaluate medical records and treatment...Physical Medicine & Rehabilitation Physician Southfield, Michigan We are hiring a Physical Medicine...
Summary The Physician Advisor optimizes efficient management of resources, ensuring patients are in the appropriate... and utilization management. Collaborates with a multidisciplinary team to implement methods and develop care management protocols...
and actively practicing. JOB SUMMARY As Physician Reviewer/Advisor for Disability Peer Review, you will utilize clinical.... Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management...
your expertise in forensic pathology to review and assess cases relevant to disability claims. The Physician Reviewer will provide... expertise strengthening your medical practice with medical necessity and utilization review/management expertise Expanded...
in forensic pathology to review and assess cases relevant to disability claims. The Physician Reviewer will provide expert... practice with medical necessity and utilization review/management expertise Expanded credentials as an expert in Independent...
guidance on medical necessity and claims processing. The Physician Reviewer will ensure that all evaluations meet client... review/management expertise Expanded credentials as an expert in Independent Medical Exams and physician advisor services...
processing. The Physician Reviewer will ensure that all evaluations meet client-specific policies and are aligned with recognized.... Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management...