Utilization Review RN - Mason, OH

This is a utilization review position where Nurses will collaborate with healthcare providers and members to promote quality member outcomes to optimize member benefits and resources. · Nurses will be responsible for reviewing patient records and treatment profiles. · Maintaining ...

This is a pool remote role for a Utilization Review Nurse responsible for evaluating medical records to assess appropriateness and efficiency of care. · ...

By joining Sedgwick, you'll be part of something truly meaningful. · ...

We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As · Utilization Review Specialist · , joining our team, you're embracing a vital mission dedicated to making communities healthier. · ...

We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. · ...

+Job summary · As a Utilization Review Specialist at Beckett Springs, you'll play a vital role in making communities healthier. You'll display knowledge of clinical criteria and managed care requirements to secure coverage for needed services. · +ResponsibilitiesDisplays knowledg ...

We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. · A Utilization Review Specialist who excels in this role: · Displays knowledge of clinical criteria · ,Completes pre and re-certifications for inpatient and outpat ...

This Utilization Review Nurse will ensure high-quality medically necessary evidence-based care for all patients. They will utilize an Integrated Case Management Model to follow patients through their continuum while facilitating functions such as utilization review cost containme ...

Aya Healthcare gives you access to the most jobs — and the most exclusive opportunities — in the industry. We have strong relationships with leading facilities nationwide... · ...

This permanent staff utilization review registered nurse job in Dayton OH allows you to join Aya for career options. · Search jobs · View pay & facility details · ...

Civil engineer project manager with strong electronic design skills and experience in civil engineering site plan design consulting. · ...

The Nurse Audit Senior will be responsible for identifying, monitoring, and analyzing aberrant patterns of utilization and/or fraudulent activities by health care providers through prepayment claims review, post payment auditing, · and provider record review.Investigates potentia ...

This is a job for Java/Web Services in Mason. · Requires an BA/BS degree in related field or technical institute training. · 9 or more years experience; multi platform experience, expert level experience with business and technical applications; · ...

Responsible for programming on specific application subsets of the companys application portfolio. · ...

This role enables associates to work virtually full-time with maximum flexibility and autonomy. · Investigates potential fraud and over-utilization by performing medical reviews via prepayment claims review and post payment auditing. · ...

The Audit Nurse role enables associates to work virtually full-time with maximum flexibility and autonomy.This approach promotes productivity and supports work-life integration while ensuring essential face-to-face onboarding and skill development. · Investigates potential fraud ...

Perform database administration tasks in Cassandra. · 8+ years of solid Cassandra DBA experience. · ...

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. · Reviews performance reports and documentation from customers and field representatives · ...

The Financial Counselor serves as the primary contact for patients and families regarding financial assistance · ...

L3Harris is dedicated to recruiting and developing high-performing talent who are passionate about what they do. Our employees are unified in a shared dedication to our customers' mission and quest for professional growth. · ...