The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. ...
A manager is looking for RN’s with at least 5 years of relevant experience.Outpatient Utilization Management experience is a plus.We find that people with Case Management experience do not always transition well into this position.Coordinates the review process for services requiring prior authoriza...
Pharmaceutical QC Data Reviewer - Contract - Lexington, MA. Proclinical is seeking a meticulous and dedicated individual for the role of Pharmaceutical QC Data Reviewer. The Pharmaceutical QC Data Reviewer will:. ...
Chemistry Data Reviewer / Quality Control Sample Management Associate. ...
In this role, you will support QC Bioassay Labs with review of test records and documents.Review executed QC test records for molecular and cell based assays.Review reagent and equipment logbooks.Additional duties may be assigned.Education & Qualifications .BA or BS degree in Biochemistry or rel...
Under the direction of the Nurse Director of the BWPO's South Shore Endoscopy Center (SSEC), the Registered Nurse GI Case Reviewer will work as a critical member of the procedural care team to support the quality, efficiency and satisfaction of care taking place at the SSEC. ...
Months Contract (Possible Extension).Experience being responsible for quality control of all scientific data generated within the Nonclinical Pharmacology group.Familiarity with Bioanalytical sample and data analysis.Attention to detail and experience with raw data QC.This position is responsible fo...
As a Vascular Surgery , Physician Clinical Reviewer you will be a key member of the utilization management team. Serve as the specialty match reviewer in Vascular Surgery cases, that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, ...
Remote position but will be required to go on site as needed.Coordinates the review process for services requiring prior authorization by ***.This includes matching the coverage request to the Medical Necessity Guidelines/Interqual Criteria or Plan Benefit Documents, documentation of the coverage de...
Seeking Bias, Sensitivity, and Fairness Reviewers for a High-Stakes Standardized Assessment. AIR will contract directly with the Reviewer under a consulting purchase order agreement. To support this process, AIR works with a cadre of writers and reviewers who are typically faculty at colleges and un...
Responsiblefor obtaining initial insurance authorizations for all applicable coverage andfor appropriate level of clinical care.Must demonstrateMcLean values of integrity, compassion and respect, diversity and teamwork,excellence and innovation consistently in their work activities andinteractions.M...
As a trusted global transformation partner, Welocalize accelerates the global business journey by enabling brands and companies to reach, engage, and grow international audiences.Welocalize delivers multilingual content transformation services in translation, localization, and adaptation for over 25...
The Medical and Promotional Reviewer will be responsible for the review and approval of medical and promotional pieces, working closely and collaboratively with other reviewers and stakeholder groups such as medical, legal, and regulatory (MLR), compliance, and commercial teams. The Medical and Prom...
The Inpatient DRG Reviewer will be primarily responsible for conducting post-service, pre-payment and post pay comprehensive inpatient DRG reviews based on industry standard inpatient coding guidelines and rules, evidence based clinical criteria plan, and policy exclusions. ...
Job Description - Utilization Reviewer - Clinical Evaluation Center Per diem (3273363). Utilization Reviewer - Clinical Evaluation Center Per diem-(3273363). ...
Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary. ...
Chemistry Data Reviewer / Quality Control Sample Management Associate. ...
Remote position but will be required to go on site as needed.Coordinates the review process for services requiring prior authorization by .This includes matching the coverage request to the Medical Necessity Guidelines/Interqual Criteria or Plan Benefit Documents, documentation of the coverage deter...
Nurse Reviewer, Endoscopy -Braintree-(3288945). Under the direction of the Nurse Director of the BWPO’s South Shore Endoscopy Center (SSEC), the Registered Nurse GI Case Reviewer will work as a critical member of the procedural care team to support the quality, efficiency and satisfaction of care ta...
The Nurse Utilization Management (UM) Reviewer is responsible for day-to-day timely clinical and service authorization review for medical necessity and decision-making. The Nurse Utilization Management Reviewer has a key role in ensuring CCA meets CMS compliance standards in the area of service deci...
Within the Finance Department, the Financial Review is a dedicated and independent function in charge of permanent controls on accounting and financial information.The Financial Review is a key component of the Enterprise Risk Management framework.As part of the second line of defense, it consists o...
Pharmaceutical QC Data Reviewer - Contract - Lexington, MA. Proclinical is seeking a meticulous and dedicated individual for the role of Pharmaceutical QC Data Reviewer. Pharmaceutical QC Data Reviewer. ...
As the largest staffing and recruitment agency in the world, we can commit to finding you the perfect role that gives you the opportunity to learn and grow in the life sciences arena.Utilizing a recruiter for your job search gives you access to a large network of top employers as well as detailed in...
We have an ongoing need for document reviewers. Remote/work from home opportunity, reviewers must reside in one of the following states: Illinois, Massachusetts, Maryland, or Virginia . ...
Job Title: Bioanalytical Data reviewer. ...