Utilization Review Specialist

Are you an experienced healthcare professional looking for a challenging and rewarding role in utilization review?We are seeking a skilled Utilization Review Specialist to join our team in a virtual process.As a Utilization Review Specialist, you will be responsible for assessing and interpreting customer needs, requirements, and medical records. You will...

Utilization Review professionals are in high demand, and Nezda Technologies Inc. is looking for skilled individuals to join their virtual team.Responsibilities:Assess customer needs and requirementsInterpret medical recordsReview medical claims for medical necessityRequirements:Active PHRN and USRN Mainland LicenseAt least 1 year of bedside experience,...

Improve patient care by working as a Utilization Management specialist in a virtual environment.Key responsibilities include assessing and interpreting customer needs, requirements and medical records, as well as reviewing medical claims for medical necessity.Required skills and qualifications include:Active PHRN and USRN Mainland License1 year Bedside...

Utilization Management SpecialistWe are seeking a skilled Utilization Management Specialist to join our team.Job Description:Our ideal candidate will assess and interpret customer needs, requirements and medical records, reviewing medical claims for medical necessity.Key Responsibilities:Assess and interpret customer needs, requirements and medical...

Job SummaryWe are seeking a highly skilled Utility Systems Manager to oversee the efficient operation and maintenance of our plant's utility equipment and systems.This role requires a strong background in mechanical engineering, with experience in designing, implementing, and maintaining complex systems.Develop and implement effective operation and...

Insurance Policy Review SpecialistThe role of Insurance Policy Review Specialist involves a thorough examination of insurance policies to ensure accuracy in premium billing. Key responsibilities include reviewing and reconciling insurance policies with payment and booking records, identifying discrepancies, and documenting errors.Review insurance policies...

It is the spirit of Bayanihan that drives us to continue our legacy of excellence and commitment to care. As an organization, we achieve our successes through good, honest, and persevering hard work - TOGETHER. It is in this way in which our company was built; we progressed as the country's leading Pharmaceutical company, not by sheer luck, but by pure...

It is the spirit of Bayanihan that drives us to continue our legacy of excellence and commitment to care. As an organization, we achieve our successes through good, honest, and persevering hard work - TOGETHER. It is in this way in which our company was built; we progressed as the country's leading Pharmaceutical company, not by sheer luck, but by pure...

OverviewPosition SummaryWe are seeking a highly skilled and detail-oriented Peer Review Specialist to support our Residential, PHP, and IOP levels of care. This individual will be responsible for conducting peer reviews, case consultations, and interfacing with insurance payers to obtain continued authorization. The ideal candidate will be a licensed...

Job Description:We are seeking an AI System Review Specialist to play a critical role in shaping the systems that train large language models.Main Responsibilities:Participate in new guideline pilot projects by reviewing ambiguous or edge-case examples with attention to linguistic nuance and rating logic.Identify inconsistencies, unclear instructions, or...