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CLINICAL REVIEWER, GRIEVANCE & APPEALS - REMOTE

Prepare and present clinical summations/recommendations to the Medical Director or Pharmacist, or Independent Review Organization in accordance with state and federal regulations, NCQA requirements, and internal policy for final c...

CompanyConnecticare
AddressNew York, NY
CategoryEducation/Training
Salary$63,000 - $110,000 a year
Job typeFull-time
Date Posted 2 months ago See detail

Clinical Reviewer, Grievance & Appeals - Remote

Connecticare

New York, NY

$63,000 - $110,000 a year

Prepare and present clinical summations/recommendations to the Medical Director or Pharmacist, or Independent Review Organization in accordance with state and federal regulations, NCQA requirements, and internal policy for final c...

Nurse Reviewer - Remote Oklahoma

Gainwell Technologies Llc

Lahoma, OK

$49,200 - $70,300 a year

Reviews and interprets medical records and compares against criteria to determine appropriateness and reasonableness of care; apply critical thinking and decision making skills to determine if the medical record documentation supp...

Environmental Scientist, Engineer – Senior-Level Technical Reviewer (Hybrid/Remote Work)

Toeroek Associates, Inc.

Colorado, United States

$70,000 - $100,000 a year

Conducts technical reviews of highly-technical documents prepared by facilities, states, tribes or other Federal agencies. Evaluates complex groundwater contamination, fate and transport, work plans, remediation plans, monitoring...

Processor, COB Review - Remote Must reside in (CA)

Molina Healthcare

California City, CA

Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level....

Behavioral Health Care Advocate - Utilization Review (Outpatient) - Remote

Optum

Minnesota, United States

$58,300 - $114,300 a year

Focus on outpatient Commercial, Medicaid and Medicare Behavioral Health services. Conducting outpatient reviews to determine appropriate care. Assessing if member care meets coverage guidelines. Shaping member treatment in partner...

Remote Document Review Attorney (Temporary)

Trustpoint International, Llc

Charleston, SC

$26 an hour

401(k). Health insurance. 8 hour shift. Monday to Friday. Overtime....

Remote WCRC Medical Reviewer

Maximus

Remote

$50 - $52 a day

Maximus- REMOTE. Must have Workers Compensation Experience . Must be available to review 25-30 hours per week. Supplemental Opportunity. Templates for reviewing. Flexible schedule. Active license and no history of major disciplina...

Sr Specialist, Process Review - Remote

Molina Healthcare

Long Beach, CA

$44,936.59 - $97,362.61 a year

Conduct interviews with staff and management to assess internal business processes within a department or function to ensure compliance with existing organizational Policies and Procedures, Standard Operating Procedures and other...

Tax Plan Advisor - Remote

Action Accounting

Remote

$75,000 - $110,000 a year

3 years. Monday to Friday. What specific experience do you have with Tax Planning? What specific experience do you have with Corvee and/or ProConnect? Tax Planning: 3 years (Required). Corvee and/or ProConnect Tax Planning Softwar...

Environmental Scientist, Engineer - Senior-Level Technical Reviewer (Hybrid/Remote Work)

Toeroek Associates, Inc.

Kansas City, KS

Conduct technical reviews and preparing technical reports and other documents on topics associated with site investigation, characterization, remedial selection, and remedy implementation. Perform internal peer review of technical...

Environmental Scientist, Engineer - Senior-Level Technical Reviewer (Hybrid/Remote Work)

Toeroek Associates, Inc.

Chicago, IL

Conduct technical reviews and preparing technical reports and other documents on topics associated with site investigation, characterization, remedial selection, and remedy implementation. Perform internal peer review of technical...

Allstate Financial Services - Principal Review Consultant I - Remote/Home Based

Allstate

Chicago, IL

$63,500 - $108,500 a year

Review new accounts to determine client suitability and best interest utilizing firm documents and defined parameters. Approve or reject trades and transactions as a Principal of the Firm. Communicate via phone or email with regis...