perspective on workplace flexibility. Position Purpose: Performs clinical reviews needed to resolve and process appeals... to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices Performs...
and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance... with interdepartmental teams to improve clinical appeals processes and procedures to prevent recurrences based on industry best practices...
Demonstrates thorough knowledge base of clinical practice through written documentation and contributions at team meetings..., knows eligibility criteria, types of services and clinical information necessary for referral, key diagnostic...
reimbursement, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting... Utilization Management (UM) Clinician facilitates a continuum of service while promoting positive outcome and optimal...
reimbursement, through coordination of patient care, daily clinical reviews, quality documentation, appeals, and reporting... Utilization Management (UM) Clinician facilitates a continuum of service while promoting positive outcome and optimal...
The Senior Clinician is primarily responsible for oversight and coordination of clinical services offered to assigned... clients, including the provision of individual, group and family therapy. The Senior Clinician also provides training...
feedback to the clinical management regarding clinician documentation, risk management, and compliance audit findings...Clinical Quality Nurse Specialist 40hrs/week If you are longing to put everything you’ve learned as a nurse...
to provide efficiencies in operational workflows related to clinician coding. Review and Resolution of Interdepartmental Coding... Response: Conducts Trains new coders to utilize the medical record, clinical, coding and abstracting systems, in conjunction...
, and state regulation, at clinical sites where the clinician is assigned. The provider is expected to function as a member... of appropriate levels of care, arbitration of clinical appeals, etc. Provide education about medical complications and comorbidities...
stays and timely appeals of denied cases. Works closely with the Directors of Clinical, Intake and Nursing and assist...Job Description: Responsibilities Roxbury is currently recruiting for a dedicated and detail oriented clinician...
discrepancies, CCI edits, and charge review Serve as a clinical resource for appeals and denials Review/update of Charge Master... of Managers, RNs, and Patient Service Staff, this role is for you! Team Impact As the Clinical Nurse Manager, you will provide...
stays and timely appeals of denied cases. Works closely with the Directors of Clinical, Intake and Nursing and assist...Job Description: Responsibilities Roxbury is currently recruiting for a dedicated and detail oriented clinician...
for medical policy/medical review, appeals, quality, clinical development of medical cost reduction initiatives and serving as the... for MassHealth’s Primary Care Clinician Plan. The MassHealth CMO, directly and through the staff of OCA, serves as a clinical...
by the company’s policies and procedures under the direct supervision of the Clinical Program Manager. Skywood is part... completion. Manages front line crisis situations when clients contact and want to speak to clinician. Completes MS4 admissions...
and its clinical portal helps streamline clinician workflow. BDxConnect Portal is our efficient, easy-to-use patient registration... and management portal that helps improve clinical workflows. Our CAM Report provides clinically actionable data that is reported...
by the company’s policies and procedures under the direct supervision of the Clinical Program Manager. Skywood is part... completion. Manages front line crisis situations when clients contact and want to speak to clinician. Completes MS4 admissions...
psychiatric treatment plans with the patient’s primary care provider and other clinical providers or staff. Participates in case... with other clinic staff and help patients with disability program applications and appeals when necessary. Provides integrated mental...
psychiatric treatment plans with the patient’s primary care provider and other clinical providers or staff. Participates in case... with other clinic staff and help patients with disability program applications and appeals when necessary. Provides integrated mental...
, helping them navigate formulary restrictions and prior authorization requirements Review and submit appeals for specialty... medications Review and submit prior authorizations for specialty medications Review patient records, lab results, other clinical...
, and educating the patient and caregivers as well as the nursing staff. She/he is a clinician, educator, investigator, consultant..., and leader. She/he makes clinical judgments based upon a synthesis of current research, concepts, principles, theories...