Analyst - Clinical Review - Detroit

This position focuses on clinical review of patient medical records and provider billing. Candidates must be able to interpret patient claims data for inconsistencies, completeness and quality. · ...

The Clinical Review position focuses on clinical review of patient medical records and provider billing. · Bachelor's Degree in a related field is preferred. · Two (2) years of experience in a related field is required. · ...

Navigates patients with inadequate access to resources; provides referrals to affordable community based resources as appropriate. Manages EPIC work queues, obtains insurance referrals, and prepares patient care requests for review. · ...

The Clinical Review Specialist plays a critical part in ensuring accurate clinical documentation, · compliance with regulatory standards, · and optimized reimbursement processes.Review · & evaluate clinical documentation for accuracy, · & completeness, · & compliance with regulat ...

+ Clinical Review Specialist · Job summary · The Clinical Review Specialist is responsible for reviewing clinical documentation to ensure accuracy, completeness, and compliance with regulatory and payer requirements. · + Qualifications Experience with clinical documentation revi ...

We are seeking a knowledgeable and detail-oriented Clinical Review Specialist to join our corporate team. This role plays a critical part in ensuring accurate clinical documentation, compliance with regulatory standards, and optimized reimbursement processes. · Experience with cl ...

Under the supervision of the Medical Director, the Psychiatrist will perform clinical duties and activities as directed, covering the continuum of intensive crisis stabilization services (ICSS) including Crisis Stabilization Unit. · Provides direct clinical/patient care duties an ...

Join our client's MA Inpatient Precertification team and support high-quality patient care through comprehensive utilization review. · ...

Job Summary · We are seeking a Clinical Peer Reviewer to join our team. The successful candidate will review patient information to ensure treatment/service provided falls within plan guidelines and that the service was appropriate for the condition. · Responsibilities: ...

The Psychiatrist will perform clinical duties and activities as directed.Under the supervision of the Medical Director, · The Psychiatrist will provide direct clinical/patient care duties and responsibilities as required. · ...

The Psychiatrist will perform clinical duties and activities as directed, covering the continuum of intensive crisis stabilization services (ICSS) including Crisis Stabilization Unit, Behavioral Health Urgent Care, and Mobile Crisis Services. · Provides direct clinical/patient ca ...

The Medical Director for Clinical Transformation is a physician who sees mostly adult patients in their clinical practice. This physician serves as a key clinical leader within the Mosaic Clinically Integrated Network (CIN), responsible for guiding strategic initiatives that enha ...

This is a quality improvement specialist role that involves monitoring patient care for quality assurance and utilization review activities. · ...

The Medical Director for Clinical Transformation- Surgical Specialist is a physician who sees mostly adult patients in their clinical practice. · This physician serves as a key clinical leader within the Mosaic Clinically Integrated Network (CIN), responsible for guiding strategi ...

The RN Clinical Appeals Nurse provides support for internal appeals clinical processes ensuring that appeals requests are reevaluated in alignment with applicable federal and state regulatory requirements Molina policies and procedures and medically appropriate clinical guideline ...

Assist in the development testing and validation of Electronic Data Capture EDC systems Case Report Forms CRFs. · ...

+Job summary · Medical Director and Adult Outpatient Psychiatrist · +ResponsibilitiesPerforms all duties and responsibilities required of a psychiatrist. · Provides quality and cost-effective care for the designated patient population in accordance with accepted medical standards ...

Job Description: · We are seeking a qualified Adult Psychiatrist to provide initial and annual psychiatric evaluation and medication reviews at our CMHC. This position requires working with adult consumers (18 & older) with mental illness, developmental disabilities, and co-occur ...

The Chief Medical Officer (CMO) leads the overall clinical vision for the organization.The position provides medical oversight, expertise and leadership to ensure the delivery of affordable quality health, dental and behavioral health services. · ...

A Clinical Exercise Physiologist (CEP) evaluates responses to exercise and implements behavior change techniques to promote healthy lifestyles. · ...