Physician Reviewer - Hingham, MA

The Physician Reviewer is responsible for evaluating clinical service requests made by BCBSMA members and providers. · ...

Ready to help us transform healthcare? Bring your true colors to blue. · The Role · The Physician Reviewer is responsible for evaluating pre & post-service clinical service requests made by BCBSMA members and providers. The Physician Reviewer uses their clinical judgment in conju ...

Ready to help us transform healthcare? Bring your true colors to blue. The Role · The Physician Reviewer is responsible for evaluating clinical service requests made by BCBSMA members and providers. The Physician Reviewer uses his/her clinical judgment in conjunction with BCBSMA ...

Ready to help us transform healthcare? Bring your true colors to blue.  · The Role · The Physician Reviewer is responsible for evaluating pre & post-service clinical service requests made by BCBSMA members and providers.  The Physician Reviewer uses their clinical judgment in con ...

The Physician Reviewer is responsible for evaluating pre & post-service clinical service requests made by BCBSMA members and providers. · Apply BCBS Criteria and guidelines to case reviews of BCBS members in order to determine if coverage of the requested service is appropriate,A ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

The Physician Reviewer is responsible for evaluating clinical service requests made by BCBSMA members and providers. · This is a part-time position working roughly 30 hours per week. · We are committed to investing in your development and providing the necessary resources to enab ...

Ready to help us transform healthcare? Bring your true colors to blue.  · Job Profile: Appeals Nurse Reviewer · Job Code: HCM101 · Business Title: Appeals Nurse Reviewer · Reports To:  Patricia Corsini RN, BSN · The Role · The Clinical Appeals Nurse Reviewer facilitates, coordin ...

Job Description Summary · Under experienced leadership the Professional Surgical Coder is an advanced coding position that is responsible for accurate and timely assignment of codes to diagnoses and procedures for all outpatient and inpatient diagnostic and procedural coding. Usi ...

The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service, pre-payment environment. · ...

Job summary The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service pre-payment environment In this position you will leverage your deep clinical expertise and business acumen to ensure all claims ...

The Physical Therapy Utilization Management Reviewer evaluates services for appropriateness and medical necessity. · Evaluate members' clinical status and benefits. · Analyze clinical outcomes and quality of service. · ...

The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and medical necessity of outpatient rehabilitation and other services within scope of practice per business needs. · The role requires collaboration with a team of professionals ...

The PT Utilization Management Reviewer is responsible for facilitating care for members who may have complex healthcare needs. · This position is self-directed and works independently to facilitate care using clinical skills · ...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partne ...

Participates in technical duties directly involved with the CT Scanner including developing, initiating and monitoring procedures for the effective utilization of this unit. · Maintains equipment for proper diagnostic imaging. · ...

Participates in technical duties directly involved with the CT Scanner including developing, initiating and monitoring procedures for the effective utilization of this unit. · ...

The Post-Service Claims Nurse Reviewer is a pivotal role responsible for safeguarding the integrity of our claims process in a post-service, pre-payment environment. · This position requires close collaboration across departments and working collaboratively with the FEP Business ...

Job Description Summary · Dana-Farber Cancer Center is hiring an experienced Oncology RN to coordinate cutting-edge clinical trials. Monday through Friday, no weekends, no holidays. · The clinical Research Nurse will provide direct patient care to patients enrolled in or consider ...

The RN Case Manager is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs. · Engage members in appropriate plans of care. · Promote member compliance with treatment plan. · ...