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JOB TITLE (#25193 ) : Psychiatrist / VA Reviewer - Remote
Minimum of 5 years active clinical practice within the specialty.
Greenlife Healthcare Staffing is currently seeking a Psychiatrist - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Psychiatrist / VA Reviewer :
* Hold a current, non-restricted license in a U.S. state or territory;
...

JOB TITLE (# 25021 ): Mental and Behavioral Health PA / VA Reviewer - Remote
Minimum of 5 years active clinical practice within the specialty and 2 years of recent experience
Greenlife Healthcare Staffing is currently seeking a Mental and Behavioral Health Physician Assistant - VA Reviewer to fill an opening with a Non-profit organization
Requirements of the Mental and Behavioral He...

Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a ...

Job Description
Job Description...
* Performs utilization management reviews in accordance with federal and state regulations
* Maintains compliance with regulatory changes affecting utilization management
* Perform UM reviews (prospective/concurrent/retrospective) for inpatient services according to the NCQA, URAC, CMA & DOH standards and client requirements and/or policies
...

JOB SUMMARY
The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.
The QA Specialist is responsible for the timely completion and overall completeness of a reviewer report. Completeness is determined by customer requirements,...

Job Category:
Revenue Cycle
Work Shift/Schedule:
8 Hr Morning - Afternoon
Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.
About the Role:
Job Summary
The Coding Quality Reviewer II is responsible for performing quality analysis of coded medical records, documenting the analysis, summarizing the metrics and reporting quality statisti...

Company Overview
The Enlyte Family of Businesses
Mitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Ou...

Company Overview
The Enlyte Family of Businesses
Mitchell | Genex | Coventry
Enlyte is the parent brand of Mitchell, Genex and Coventry, an organization unlike any other in the Property & Casualty industry, bringing together three great businesses with a shared vision of using technology innovation, clinical services and network solutions to help our customers and the people they serve. Ou...

The Customer Service Representative is responsible for receipt of new cases and ensuring proper system drafting and setup. The CSR also is responsible for taking direction and facilitating the case assignment/scheduling process.
MAJOR DUTIES & RESPONSIBILITIES
* Handling Receipt of New Cases:
* Intake new cases and review/verify information and requests. Draft cases by entering inform...

Overview
Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform® provides a practical, sustain...

JOB SUMMARY
The QA Specialist plays an integral role in the review process as they are responsible for communicating with the customer, reviewer, and management to ensure a completed report is delivered by the customer requested due date.
In addition to the duties of the QA Specialist, the Clinical QA Specialist is also responsible for ensuring that the clinical content is accurate and adequate...

Job Summary:
Reviews coverage requests using established timelines and all relevant clinical information for appropriate coding, medical necessity, care coordination, place of service, and care rendered. Summarizes findings and facilitates appropriate authorization or payment. Prepares information for review by the physician reviewer according to established procedures. Determine if new servi...

JOB SUMMARY
The Customer Service Representative is responsible for receipt of new cases and ensuring proper system drafting and setup. The CSR also is responsible for taking direction and facilitating the case assignment/scheduling process.
Dane Street's success relies on individual and team contributions every day. We care for our customers, each other and Dane Street. It is the responsibility...

Your Future Evolves Here
Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/lif...

Company Overview
Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.
Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership...

Company :
Highmark Inc.
Job Description :
I. GENERAL OVERVIEW:
• Receive, review and make determinations regarding physician reviewer assignments for medical management decisions. Cases requiring physician review are provider and member requests, received from Medical Management & Policy (MM&P) and Member Grievance Departments.
• Responsible for management of Peer to Pe...