Concurrent Review Jobs Near Me

Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for members to ensure optimum ...

Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...

Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...

Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...

Job Duties • Facilitates medical review of prospective, retrospective, and concurrent review of appeals for denied prior authorizations. Includes standard and expedited cases, inpatient, outpatient ...

Job Duties • Facilitates medical review of prospective, retrospective, and concurrent review of appeals for denied prior authorizations. Includes standard and expedited cases, inpatient, outpatient ...

Job Duties Facilitates medical review of prospective, retrospective, and concurrent review of appeals for denied prior authorizations. Includes standard and expedited cases, inpatient, outpatient ...

Job Duties • Facilitates medical review of prospective, retrospective, and concurrent review of appeals for denied prior authorizations. Includes standard and expedited cases, inpatient, outpatient ...

Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital ...

Conducts pre-certification, concurrent review, and appeals of Behavioral Health OP services. * Mentors Behavioral Health Care Management staff by assisting in training, attending utilization ...

Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review. Assesses services for Members to ensure optimum ...

Conducts pre-certification, concurrent review, and appeals of Behavioral Health OP services. * Mentors Behavioral Health Care Management staff by assisting in training, attending utilization ...

Conduct prospective, concurrent, and retrospective drug utilization reviews. * Evaluate prescribing patterns against clinical guidelines and formulary criteria. * Identify potential drug interactions ...

Superior organizational skills and attention to detail, with the ability to effectively prioritize a high volume of concurrent reviews. * Self-starter who can work independently with little direction ...

Reviews authorization packets for completeness and accuracy prior to MCO submission. * Submits initial, concurrent, and reauthorization requests to Medicaid Managed Care Organizations within required ...

Assess the appropriateness of the level of care, diagnostic tests and clinical procedures for utilization review on a concurrent basis * Work closely with Utilization Review team in coordinating C-9 ...

Assess the appropriateness of the level of care, diagnostic tests and clinical procedures for utilization review on a concurrent basis * Work closely with Utilization Review team in coordinating C-9 ...

Assess the appropriateness of the level of care, diagnostic tests and clinical procedures for utilization review on a concurrent basis * Work closely with Utilization Review team in coordinating C-9 ...

Superior organizational skills and attention to detail, with the ability to effectively prioritize a high volume of concurrent reviews. * Self-starter who can work independently with little direction ...

Superior organizational skills and attention to detail, with the ability to effectively prioritize a high volume of concurrent reviews. * Self-starter who can work independently with little direction ...