Orthopedic Surgery Telecommute Medical Review ConcentraOrthopedic Surgery Telecommute Medical ReviewSecaucus, New JerseyCurrent, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post-graduate experience in direct patient care JOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills -Demonstrated ability to perform review services.
Neurosurgeon Telecommute Medical Review ConcentraNeurosurgeon Telecommute Medical ReviewNewark, New JerseyCurrent, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post-graduate experience in direct patient care JOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills -Demonstrated ability to perform review services.
NewClinical Review Nurse - Concurrent Review Centene Corporation GroupClinical Review Nurse - Concurrent ReviewNYRemote$27.02–$48.55 / hourPosition Purpose: Performs concurrent reviews, including determining member's overall health, reviewing the type of care being delivered, evaluating medical necessity, and contributing to discharge planning according to care policies and guidelines. Collects, documents, and maintains concurrent review findings, discharge plans, and actions taken on member medical records in health management systems according to utilization management policies and guidelines.
NewRN - Utilization Review / Quality Assurance Analyst (QAA) Integrated Resources, IncRN - Utilization Review / Quality Assurance Analyst (QAA)New York, NY$60–$65 / hourParticipate and document incident, grievance, and complaint case conferences to provide support and guidance to team; ensure that patients are connected to appropriate levels of care and that all required/supporting documentation is on record as needed. Assist with the execution and monitoring of written action plans that identify a specific, measurable, attainable set of activities designed to improve any deficits observed in documentation/records in collaboration with the quality manager.
Clinical Readmission Review Auditor III ExlService Holdings IncClinical Readmission Review Auditor IIINYRemote$70,000–$98,700 / yearThis role focuses on evaluating the clinical circumstances surrounding related inpatient admissions, the care delivered, discharge planning, and whether the subsequent admission may have been clinically related or potentially preventable. Clinical expertise: Strong knowledge of inpatient care, disease progression, discharge planning, transitions of care, medical necessity, and factors contributing to readmissions.
NewUtilization Review Nurse Oscar Health IncUtilization Review NurseNew York, NYRemote$35–$45.94 / hourWork Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. Requirements: Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC).
Associate II- Document Review American Red Cross Blood ServicesAssociate II- Document ReviewNYAmeriCorps, the federal agency that brings people together through service, and its partners - the Peace Corps, AmeriCorps Alums, National Peace Corps Association, and the Service Year Alliance - launched Employers of National Service to connect national service alumni with opportunities in the workforce. WHERE YOUR CAREER IS A FORCE FOR GOOD (Key Responsibilities): Review and correct electronic and manual versions of donor collections operations documents and assist with donor safety and patient safety issues as related to results of the review.
Utilization Review Coordinator (NY HELPS), Manhattan Psychiatric Center, P27097 New York State Thruway AuthorityUtilization Review Coordinator (NY HELPS), Manhattan Psychiatric Center, P27097New York, NY$70,579–$89,645 / yearNotes: In order to be eligible for appointment and to maintain employment, you cannot be listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted program). The Mission of the New York State Office of Mental Health (OMH) is to promote the mental health of all New Yorkers, with a focus on providing hope and supporting recovery for adults with serious mental illness and children with serious emotional disturbances.
Utilization Review RN - PT - Day - Utilization Resource Mgmt Pennington NJ Capital HealthUtilization Review RN - PT - Day - Utilization Resource Mgmt Pennington NJHopewell, New JerseyOccasional physical demands include: Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Keyboard use/repetitive motion, Talk or Hear. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity.
Contract Review Attorney SRS Acquiom Inc.Contract Review AttorneyNYRemote$105,000–$120,000 / yearReview transaction documents (usually a merger, asset, or stock purchase agreement, escrow and paying agent agreement, allocation spreadsheet, and supporting or ancillary agreements) for an understanding of post-closing rights and obligations of the parties (for example, rights to deferred compensation, earnouts, and releases of escrow and indemnification obligations). By bringing efficiency, expertise, and purpose-built technology to complex financial transactions, we help sophisticated deal parties focus on building great businesses and maximizing value.
Utilization Review RN - Per Diem - Day - Utilization Resource Mgmt Pennington NJ Capital HealthUtilization Review RN - Per Diem - Day - Utilization Resource Mgmt Pennington NJHopewell, New JerseyOccasional physical demands include: Climbing (e.g., stairs or ladders), Carry objects, Push/Pull, Twisting, Bending, Reaching forward, Reaching overhead, Keyboard use/repetitive motion, Talk or Hear. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity.
Annual Product Quality Review Program Lead Tris PharmaAnnual Product Quality Review Program LeadMonmouth Junction, NJ$100,000–$145,000 / yearMinimum education and years of relevant work experience: Bachelors degree in Chemical Engineering, Pharmaceutical Sciences, Chemistry, or a related scientific discipline and minimum 5 years in quality systems, process validation, product quality review or quality engineering in the pharmaceutical or biotechnology industry in positions of increasing technical responsibility OR combination of education and related quality systems, process validation, product quality review or quality engineering in the pharmaceutical or biotechnology industry in positions of increasing technical responsibility. Analyzes and interprets large datasets from Manufacturing, Packaging, Laboratory departments, complaints, deviations, Corrective Action Preventive Action (CAPAs), change controls and stability programs to identify statistically significant trends, process shifts and emerging quality risks including, but not limited to: analyzing Deviation and Rejection Profiles, trending manufacturing deviations, batch failures, yield losses and Out-of-Specification (OOS) laboratory findings (i.e., dissolution, uniformity, particle size), etc.
IMG for chart review CROSS COUNTY MEDICAL CAREIMG for chart reviewElmont, NYPart timeCross County Medical Care is a trusted healthcare provider serving the Bellerose, NY community with a commitment to high-quality, patient-centered care. This is a fantastic opportunity for a medically trained professional to contribute their clinical knowledge in a detail-oriented, documentation-focused role.
Scientific Review Committee Administrator Hospital for Special SurgeryScientific Review Committee AdministratorNew York, NY$86,000–$131,375 / yearThe salary of the finalist selected for this role will be determined based on various factors, including but not limited to: scope of role, level of experience, education, accomplishments, internal equity, budget, and subject to Fair Market Value evaluation. Contribute and/or lead special projects and strategic initiatives, including presentations to leadership, committee participation, process improvement efforts, operational retreats, and other institutional priorities as assigned.
Med Records Coder III University of RochesterMed Records Coder IIINew York, NY$21.78–$30.53 / hourAmerican Health Information Management Association (AHIMA) accreditation examination for Registered Health Information Administrator (RHIA) or (Registered Health Information Technician) RHIT or Certified Coding Specialist (CCS) preferred. Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation as per designated workflow.
Institutional Review Board Analyst Albert Einstein College of MedicineInstitutional Review Board AnalystEinstein/Resnick - Bronx, New YorkAlbert Einstein College of Medicine considers factors such as (but not limited to) scope and responsibilities of the position, candidate's work experience, education/training, key skills, internal peer equity, as well as, market and organizational considerations when extending an offer. Coordinates review activities with institutional stakeholders and oversight committees, including Research Compliance, Institutional Biosafety Committee (IBC), Legal Affairs, Clinical Trials Administration, and other departments, as necessary.
NewDirector, Management Review Strategy & Insights Bristol-Myers Squibb CoDirector, Management Review Strategy & InsightsMadison, NJ$200,940–$243,492 / yearPredictive insight & data integration - Analyze quality performance data and metrics to identify trends, patterns, and areas of concern; partner with QRM, External Engagement, Quality Metrics, Competitive Compliance, and other GxP functions to integrate internal and external data, delivering insights that drive proactive, predictive discussion and risk mitigation at Quality Councils. Predictive analytics tool development - Lead the design and development of a data-driven tool to support Quality Council discussions, integrating internal and external data sources to proactively surface key risks and answer critical questions that inform decision-making across the organization.
Certified Medical Assistant Vanguard Medical GroupCertified Medical AssistantRandolph, New Jersey$19–$25 / hourFull timeMAs are responsible for assisting with direct patient care, preparing for visits and procedures, and collaborating with both clinical and administrative teams to deliver team-based, patient-centered care. Medical Assistants (MAs) are integral members of the care team, supporting providers and clinical operations to ensure efficient, high-quality care and an excellent patient experience.
Lead Certified Medical Assistant Vanguard Medical GroupLead Certified Medical AssistantCranford, New Jersey$25–$27 / hourFull timePlease note that individual total compensation will be determined at the Company’s sole discretion and may vary based on several factors, including but not limited to: location, skill level, years and depth of relevant experience, and education. Collaborate with providers, nurses, medical receptionists, and other care team members to enhance workflows and the overall patient journey.
Certified Medical Assistant III Vanguard Medical GroupCertified Medical Assistant IIIRandolph, New Jersey$23–$25 / hourFull timeIn addition to performing core Medical Assistant responsibilities, this position provides training, support, and coaching to new clinical support staff and Medical Assistants to help them successfully support clinicians, patients, and office workflows. This role follows established clinical workflows and participates in both clinical and administrative tasks to support efficient, high-quality care delivery.