Contract Physician – Medical Necessity Review - United States

PWN Remote Care Services, P.A. (PWN) is a telehealth practice facilitating access to high-quality, diagnostic-driven patient care. PWN is part of a provider network affiliated with Everlywell, a leading remote-based healthcare company. At PWN our mission is to enable access to di ...

We are seeking an experienced Registered Nurse (RN) with multi-state experience to perform utilization reviews, medical necessity evaluations, demand package reviews, and provide litigation support including deposition and testimony services when needed. This position is RN only. ...

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Surgeons with an active New York medical license and Workers Compensation Board Certification to conduct ...

Acentra Health está buscando un educador clínico para unirse al equipo creciente. · ...

Evaluating medical treatment requests to determine medical necessity. · ...

We are seeking an experienced Registered Nurse (RN) with multi-state experience to perform utilization reviews, medical necessity evaluations, demand package reviews, and provide litigation support including deposition and testimony services when needed. This position is RN only. ...

The Utilization Management Nurse is responsible for the delivery of the Utilization Management process to include: making clinical recommendations regarding medical necessity for admission, · continued stay and the development/implementation of a comprehensive case management tre ...

General Statement of Duties: The Utilization Review Manager is responsible for coordinating, managing, and documenting medical necessity and authorization processes for behavioral health services reimbursed by commercial payers. This role supports residential treatment, partial h ...

The After Hours Utilization Management Reviewer is scheduled to work non-traditional hours to provide access to medical necessity determinations for urgent or required coverage requests on a 24/7 basis. · Conduct utilization management reviews by assessing medical necessity, appr ...

The Clinical Bill Review Nurse/Certified Coder is responsible for reviewing medical bills and associated documentation to ensure accuracy, medical necessity, and compliance with workers compensation guidelines. · ...

· Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income.  This is a telework ...

· Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income.  This is a telework ...

· Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income.  This is a telework ...

· Dane Street is an Independent Review Organization and a national provider of Utilization Review services (among other offerings) and we are expanding our physician panel resulting in opportunities for non-traditional physician work and supplemental income.  This is a telework ...

The position is responsible for scheduling patient appointments and ensuring medical necessity compliance. · Schedules patient appointments and enters required information in the computer system in an accurate and timely manner. · Obtains demographic, insurance and financial info ...

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for ...

Position is responsible for scheduling patient appointments and ensuring medical necessity compliance. · ...

Position is responsible for scheduling patient appointments, · scheduling patient appointments and enters required information in the computer system in an accurate and timely manner. · Ensures medical necessity compliance by obtaining necessary data review Compliance System comm ...

Seeking a Medical Director of Utilization Management Full Time: 40 hrs/wk Mon-Fri 8A-5P Serve as the clinical expert on physician practice patterns, over- and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with g ...

+Job summary · Imagine360 is seeking a Medication Benefit Review Nurse – GeneCell Therapy to join the team.The Medication Benefit Review Nurse – GeneCell Therapy (CGT) is responsible for conducting comprehensive utilization reviews... ...