Utilization Review Nurse
Providence, RI · On-site
... documented system information as well as any additional records/data presented to develop a ... · MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience ...
Providence, RI · On-site
... documented system information as well as any additional records/data presented to develop a ... · MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience ...
Providence, RI · On-site
... documented system information as well as any additional records/data presented to develop a ... · MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge. · MUST HAVE UM experience ...
Lincoln, RI · On-site
This role assists with document review, project planning, subcontract administration, cost control, and field coordination while gaining exposure to all phases of construction project management. Key ...
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Lincoln, RI · On-site
This role assists with document review, project planning, subcontract administration, cost control, and field coordination while gaining exposure to all phases of construction project management. Key ...
Be Seen First
Providence, RI · On-site
$50K - $59K/yr
Draft, review, and prepare legal documents * Manage and organize case files and related documents * Communicate with clients to obtain and relay information * Assist with trial preparation and court ...
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Be Seen First
Providence, RI · On-site
$50K - $59K/yr
Draft, review, and prepare legal documents * Manage and organize case files and related documents * Communicate with clients to obtain and relay information * Assist with trial preparation and court ...
Carolina, RI · On-site +1
Manages day-to-day activities for assigned staff. Identifies training needs and verifies accuracy ... Develops/maintains/updates procedures/documentation for conducting audits. Develops/communicates ...
Carolina, RI · On-site +1
Manages day-to-day activities for assigned staff. Identifies training needs and verifies accuracy ... Develops/maintains/updates procedures/documentation for conducting audits. Develops/communicates ...
... document review software, docketing/case management, and overall client service. * Learn/develop technical proficiency in e-discovery database use and management; AI software tools; internet ...
... document review software, docketing/case management, and overall client service. * Learn/develop technical proficiency in e-discovery database use and management; AI software tools; internet ...
Familiarity with Navy or DoD technical publication standards and document review processes. * Experience with SharePoint or other Government document-management systems. Company Overview Serco Inc ...
Familiarity with Navy or DoD technical publication standards and document review processes. * Experience with SharePoint or other Government document-management systems. Company Overview Serco Inc ...
... document review software, docketing/case management, and overall client service. * Learn/develop technical proficiency in e-discovery database use and management; AI software tools; internet ...
... document review software, docketing/case management, and overall client service. * Learn/develop technical proficiency in e-discovery database use and management; AI software tools; internet ...
Newport, RI · On-site
... managing, revising, and distributing technical documentation to the United States Navy. Due to the ... Document Review Boards to support the entire document change process including providing ...
Newport, RI · On-site
... managing, revising, and distributing technical documentation to the United States Navy. Due to the ... Document Review Boards to support the entire document change process including providing ...
Warwick, RI · On-site
$39.59 - $45.84/hr
Partner with senior leadership to help manage active litigation matters and maintain coordination ... Familiarity with discovery processes, document review, and coordination of litigation support ...
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Warwick, RI · On-site
$39.59 - $45.84/hr
Partner with senior leadership to help manage active litigation matters and maintain coordination ... Familiarity with discovery processes, document review, and coordination of litigation support ...
Warwick, RI · On-site
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Warwick, RI · On-site
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$14.50 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$14.50 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Bristol, RI · On-site
$15.75 - $21/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Bristol, RI · On-site
$15.75 - $21/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$100K - $165K/yr
The Manager partners closely with the Director, Leave Management, to support departmental ... Ensure operational compliance through ongoing case oversight, audits, documentation reviews ...
$100K - $165K/yr
The Manager partners closely with the Director, Leave Management, to support departmental ... Ensure operational compliance through ongoing case oversight, audits, documentation reviews ...
Cranston, RI · On-site
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Cranston, RI · On-site
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Providence, RI · On-site
Manage plaintiff-side litigation matters involving medical malpractice, wrongful death ... Conduct and oversee all phases of discovery, including document review, written discovery ...
New
Quick apply
Providence, RI · On-site
Manage plaintiff-side litigation matters involving medical malpractice, wrongful death ... Conduct and oversee all phases of discovery, including document review, written discovery ...
New
Providence, RI · On-site
The Manager partners closely with the Director, Leave Management, to support departmental ... Ensure operational compliance through ongoing case oversight, audits, documentation reviews ...
Providence, RI · On-site
The Manager partners closely with the Director, Leave Management, to support departmental ... Ensure operational compliance through ongoing case oversight, audits, documentation reviews ...
$15 - $20/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$15 - $20/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Pawtucket, RI · On-site
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
Pawtucket, RI · On-site
$14.75 - $19.50/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$15.75 - $21/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
$15.75 - $21/hr
... document review consulting as well as project management. Consultants will start by learning a range of skills around data including e-discovery, digital forensics and case management. Advanced ...
New
| Aspect | Document Review Manager | Document Review Specialist |
|---|---|---|
| Credentials | Bachelor's degree; experience in legal or compliance fields | High school diploma or equivalent; relevant training or certification |
| Work Environment | Supervisory role overseeing review teams, often in law firms or corporate legal departments | Performing review tasks directly, often in legal or consulting firms |
| Responsibilities | Managing review projects, coordinating teams, ensuring quality and deadlines | Conducting document reviews, coding, and data extraction |
The Document Review Manager typically oversees review teams and manages projects, requiring leadership skills and experience. The Document Review Specialist focuses on executing review tasks directly, with less managerial responsibility. Both roles are essential in legal and compliance industries, but they differ mainly in scope and level of responsibility.
The most popular types of Document Review jobs in Rhode Island are:
For Document Review Manager jobs in Rhode Island, the most frequently searched job titles are:
The top searched job categories for Document Review Manager jobs in Rhode Island are:
Cities in Rhode Island with the most Document Review Manager job openings:

Providence, RI • On-site
Other
Re-posted 11 hours ago
Please note: Actual location may vary., RI
Contract
Job Description:
· Participates in the development and ongoing implementation of QM Work Plan activities.
· Improve quality products and services, by using measurement and analysis to process, evaluate and make recommendations to meet QM objectives
Responsibilities:
· Reviews documentation and evaluates Potential Quality of Care issues based on clinical policies and benefit determinations.
· Considers all documented system information as well as any additional records/data presented to develop a determination or recommendation.
· Data gathering requires navigation through multiple system applications.
· Staff may be required to contact the providers of record, vendors, or internal Aetna departments to obtain additional information.
· Evaluates documentation/information to determine compliance with clinical policy, regulatory and accreditation guidelines.
· Responsible for the review and evaluation of clinical information and documentation.
· Reviews documentation and interprets data obtained form clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues.
· Works Potential Quality of Care cases across all lines of business (Commercial and Medicare).
· Independently coordinates the clinical resolution with internal/external clinician support as required.
· Processes and evaluates complex data and information sets -Converts the results of data analysis into meaningful business information and reaches conclusions about the data
· Prepares and completes QM documents based on interpretation and application of business requirements
· Documents QM activities to demonstrate compliance with business, regulatory, and accreditation requirements
· Assists in the development and implementation of QM projects and activities
· Accountable for completing and implementation of QM Work Plan Activities
Experience:
· 3+ years of experience as an RN
· 1+ years of inpatient hospital experience
· Registered Nurse in state of residence
· Must have prior authorization utilization experience
· Able to work in multiple IT platforms/systems
Skills:
· MUST HAVE MEDCOMPASS or ASSURECARE exp.
· MUST HAVE MANAGED CARE exp and Medicare/Medicaid knowledge.
· MUST HAVE UM experience, inpatient utilization management review.
· MUST HAVE 1 YEAR OF UTILIZATION MANAGEMENT EXP, pref. knowledge of Milliman/MCG.
· MUST HAVE 6 months of Prior Authorization.
Education:
· Active and unrestricted RN licensure in state of residence
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com/) .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
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US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.
It services
1,001 - 5,000 Employees
Jersey City, NJ, US
2000