Utilization Review Specialist

Healthcare Utilization Specialist PositionWe are seeking a skilled professional to conduct thorough medical record reviews and implement effective utilization management strategies to reduce costs and improve patient outcomes.The ideal candidate will have a strong background in workers' compensation utilization management reviews, as well as experience in...

Job OverviewAs a Utility Engineer 1, you will be responsible for analyzing and cataloging overhead utility assets to ensure consistent, high-quality data collection.This role requires strong analytical and problem-solving skills, as well as proficiency in computer software and good written and oral communication abilities.Additionally, you will work closely...

Job Title: Utilization Management ProfessionalWe are seeking an experienced professional to fill a virtual position in medical claims review and assessment of customer needs.About the Role:This is a flexible, remote opportunity that offers a unique blend of challenge and work-life balance. The ideal candidate will have a strong background in healthcare...

Job Title: Assignment Review SpecialistWe seek a seasoned professional to assess and evaluate college-level assignments in the Humanities and Social Sciences discipline.This is a remote contract role, paid per piece, offering flexibility and autonomy.ResponsibilitiesEvaluate and grade essays, case studies, reports, and other projects in Humanities and Social...

We are seeking researchers to evaluate manuscripts for journals and publishers. This is a unique opportunity to utilize your advanced degree in clinical microbiology to contribute to the scientific community.RequirementsA PhD or MD in clinical microbiology, or equivalent qualification.Two publications in the last two years in clinical microbiology.Expertise...

As a Peer Review Specialist, you will be responsible for conducting thorough peer reviews and case consultations to support continued authorization.This role requires excellent communication skills to effectively interface with insurance payers.Main ResponsibilitiesConduct comprehensive peer reviews and case consultations to secure continued stay...

Expert Reviewer OpportunityJob SummarySeeking experienced researchers to conduct thorough peer reviews for academic journals and publishers.Key Responsibilities:Evaluate Manuscript Novelty: Assess whether the manuscript presents original research and contributes significantly to the field of study.Study Design and Methodology Evaluation: Determine if the...

Job OpportunityWe are seeking a skilled Clinical Review Nurse to conduct clinical review of cases not meeting criteria. The successful candidate will perform clinical intake and adjudicate requests as needed, while escalating to Medical Directors when required.Key Responsibilities:\

Vendor Risk Management SpecialistWe are seeking a Vendor Risk Management Specialist to fulfill key responsibilities in supply chain risk and cybersecurity management.Key Responsibilities:Participate in third-party risk management consulting engagements to identify and assess client supply chain risk and cybersecurity challenges.Support vendor identification,...

**Job Title:** Healthcare Content SpecialistWe are seeking a detail-oriented and organized individual to join our team as a Healthcare Content Specialist. The ideal candidate will have experience in medical coding, research, and communication.Responsibilities:Conduct thorough research on medical coding and billing documents to identify claim denial or...