Clinical Care Reviewer II - Massachusetts - R11559

+h2>Job Summary · Clinical Care Reviewer II – Behavioral Health is responsible for processing medical necessity reviews for appropriateness of authorization for behavioral health care services... · Complete prospective concurrent and retrospective review of Behavioral Health serv ...

We are seeking a highly skilled Cardiologist Consultant specializing in Imaging Review to provide expert analysis and interpretation of cardiac imaging studies. · This role involves collaborating with multidisciplinary teams to ensure accurate diagnosis and optimal patient care. ...

A Psychiatric Consultant (PMHNP) role at FamilyWell Health aims to enhance access to high-quality mental health services for pregnant individuals across the U.S., providing comprehensive virtual mental health services designed specifically for OB/Gyn practices. · Licensed psychia ...

+Job summary · Cases manager required to provide care and manage hospital stays for patients in MAH. · ...

The Commercial Reviewer Appraiser will report to the VP Commercial Appraisal Review Manager. · ResponsibilitiesThe Commercial Review Appraiser is primarily responsible for reviewing and providing written Standard 3 Appraisal Review Reports on externally prepared · Appraisals o ...

The Commercial Reviewer Appraiser will report to the VP Commercial Appraisal Review Manager. · The Commercial Review Appraiser is primarily responsible for reviewing and providing written Standard 3 Appraisal Review Reports on externally prepared Appraisals of commercial and inve ...

Concert Health is seeking an experienced and mission-driven Medical Director to serve as the psychiatrist lead and liaison to a valued health system partner. · This unique role combines direct clinical consultation within the Collaborative Care Model (CoCM) with clinical innovati ...

+Job Summary: · Clinical pharmacist supports patients and physicians by improving quality of patient care.+Responsibilities:Review patient care notes for prior authorization approvals. · Develop clinical protocols to improve patient adherence. · Evaluate EMR to optimize medicatio ...

We're looking for a Loan Processing Assistant to support the preparation, documentation, · and verification of loan applications.Collect review and organize applicant documents (IDs bank statements forms etc) · Verify loan application details for accuracy and completeness · Maint ...

We are seeking a talented individual for a Nurse Reviewer (RN) to support our Massachusetts contract. This role involves performing clinical reviews to determine if the medical record documentation supports the need for the service based on clinical criteria, coverage policies, a ...

Review EMS run reports for accuracy and completeness in documentation and patient care.Candidate needs to be able to read and comprehend PCR report data quickly. · ...

We enjoy the important work we do every day in service to our members partners colleagues and communities. · Under supervision Utilization Management Supervisor Behavioral Health BH Utilization Management UM Clinician responsible conducting benefit coverage reviews utilization m ...

+We encourage you to reach out and understand the opportunities that await with stable staffing, a great reputation and wonderful career experience. · +If you're looking for a career that's transformative for you and those you serve, · ...

The Physician Editor (Obstetrics-Gynecology) position requires an 80 to 90% FTE commitment for editorial work and a broad understanding of clinical issues. · ...

The Revenue Accountant role is responsible for various duties such as assisting in month end close activities reviewing and analyzing transactions general ledger accounts and company expenditures reviewing financial statements and preparing financial reports assists with external ...

This role is 100% remote. · Speech-language pathologists (SLPs) provide remote speech therapy sessions and evaluations for a diverse pediatric population. ...

100% Remote Mental Health Therapist licensed in Massachusetts to join our team of dedicated mental health clinicians under the guidance of a Behavioral Health Supervisor. · ...

Included Health is seeking a 100% Remote Mental Health Therapist licensed in Massachusetts to join our team of dedicated mental health clinicians. · ...

Leverage remote patient monitoring platform to track patient data and trends. Partner closely with clinical care team to coordinate virtual care. · ...

The Vice President Market Chief Medical Officer has accountability for ensuring that local health plan CareSource initiatives focusing on clinical excellence quality improvement appropriate inpatient and outpatient utilization affordability health system transformation including ...