MDS Utilization Review Nurse

At ISTA Solutions, we are seeking an experienced PHRN with a proven track record in dealing with US Healthcare Insurance accounts, particularly in Utilization Management. This role entails semi-back-office work involving US-based Clients related to Claims, Benefits, Eligibility, Appeals, Prior Authorization, and MDS Utilization Review.Key...

About the RoleWe are looking for an experienced PHRN to join our team at ISTA Solutions, specializing in Utilization Management. The ideal candidate will have a strong understanding of US Healthcare Insurance accounts and be able to conduct reviews in accordance with US State/Federal and other mandated regulations.Responsibilities:Perform UM reviews for...

ISTA Solutions is currently seeking an experienced PHRN to fill a key position in our team. The ideal candidate will have a strong understanding of US Healthcare Insurance accounts and be able to conduct reviews in accordance with US State/Federal and other mandated regulations.Job Description:Performs UM reviews for inpatient services according to the...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion,...

About UsWe are ISTA Solutions, a company dedicated to providing top-notch healthcare services. We are currently seeking an experienced PHRN to join our team and help us achieve our goals.Job Summary:Performs UM reviews for inpatient services, ensuring compliance with regulatory changes affecting UM.Reviews UM requests for services against established...

Get AI-powered advice on this job and more exclusive features.Responsible enough in executing the required duties of an Occupational Health Nurse in the company, work together with the Corporate Company Physician in the clinic management, wellness program, health risk assessment, promotion and surveillance, and medical management of all the employees and...

About the RoleThe Remote Nurse Coordinator is a key member of our team, responsible for coordinating patient care through remote means. This involves reviewing medical records, processing claims, and ensuring compliance with healthcare protocols.Key ResponsibilitiesCollaborate with medical professionals to ensure accurate and efficient patient care...

The Clinic Manager will handle clinic management in terms of daily clinic operations, engagement with staff, guidance in reports, audit compliance, etc. A coordinator and first line to engage with clinic site personnel to address day-to-day concerns.Duties and Responsibilities:Monitors compliance of staff with standards defined by ActiveOne specifically...

Clinical Quality & Operational Risk Management - Registered Nurse SupportSchedule: Mon-Fri onsite, 8pm-5am MNLThe Clinical Quality & Operational Risk Management (CQRM) Registered Nurse is responsible for supporting the CQRM Clinical Manager with duties as assigned.The responsibilities include but are not limited to the following:Maintain active and...

Company: Sagility PHAccount: NON-VOICE ACCOUNTSet-up: Permanent Work on siteResponsibilities/Task:( Review patient Charts / Medical Records specifically for cancer patients - Oncology )Qualifications:-Candidate must be a graduate of Bachelor of Science in Nursing-Must be a PHRN License holder only ( NON-USRN LICENSE )-Preferably with 1 year of any direct...

We are looking for a highly skilled Water Utility Project Electrical Engineer to join our team. As a key member of our project team, you will be responsible for ensuring the quality and compliance of electrical systems and installations for a water utility project.About The RoleIn this role, you will work closely with the project team to implement quality...

Fresenius Medical Care is the world's leading provider of dialysis products and services. We care for people with chronic kidney failure, of whom around 3.4 million worldwide depend on dialysis treatment. Thanks to our decades of experience in dialysis, our innovative research and our value-based care approach, we can help them to enjoy the very best quality...

Nurturing Family CultureWe value our employees as part of our family and strive to provide a supportive environment that fosters growth and development.Job Title:Maintenance EngineerJob Description:Implement effective operation and maintenance of assigned Work Center's utility equipment and systems ensuring effective, reliable and efficient plant utility...

We are seeking a highly skilled Registered Nurse to join our team in the Clinical Quality and Operational Risk Management role. As a key member of our team, you will support the CQRM Clinical Manager with various duties, including maintaining active and unencumbered PHP or NCLEX Registered Nurse licenses.Main Responsibilities:Maintaining active and...

Job Description">We are currently seeking a registered nurse with experience in oncology care to join our team. As a member of our team, you will be responsible for reviewing patient charts and medical records specifically for cancer patients. You will also work closely with other healthcare professionals to provide comprehensive care to our clients.

Company: Sagility PHAccount: NON-VOICE ACCOUNTSet-up: Permanent Work on siteResponsibilities/Task:( Review patient Charts / Medical Records specifically for cancer patients - Oncology )Qualifications:-Candidate must be a graduate of Bachelor of Science in Nursing-Must be a PHRN License holder only ( NON-USRN LICENSE )-Preferably with 1 year of any direct...

Greetings from the RelianceUnited Recruitment TeamThank you for your interest in being part of RelianceUnited's Onsite Clinic Management Team (Flexicare)To start your application process and prepare for a virtual interview, please fill up this form which will take 5 - 10 minutes to complete. You will also be required to upload your CV (.doc, .pdf...

PH Nurses - Clinical Auditor | WFH | TNKISTA Solutions, an outsourcing/offshoring company, is in search of an experienced PHRN or RN Clinical Auditors to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA...

We are looking for a highly motivated Marketing Assistant to join our team at AHEAD Tutorial and Review Center. As a Marketing Assistant, you will be responsible for designing and implementing marketing campaigns, coordinating seminars/workshops, and ensuring potential students and parents are informed about our services.Responsibilities:Develop a thorough...

Job Title: Marketing AssistantWork Set-up: Fully RemoteContract Duration: 3 months, with potential for extension based on performanceCompensation: Php125 per hourEmployment Type: Independent ContractorWorking Hours: 2–4 hours per day (Monday to Saturday), FlexibleAbout Us:AHEAD Tutorial & Review Center has been at the forefront of academic excellence since...