Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Roles
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
Req ID: 379926 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are
Remote Patient Care Coordinator — US Cardiology Team (RN/MA/CNA) | $7–8/hr Coordinates patient care and clinical operations for a US-based cardiology team, with a focus on patient communication, documentation, and workflow support. Sector Healthcare — Cardiology /
Profile Summary: Favorably impact Stop Loss risk profile through early identification of potential high cost patients. Profile Description: • Serves as a subject matter expert in the evaluation of medical information to clarify diagnoses, evaluate the
Performs clinical reviews needed to resolve and process appeals by reviewing medical records and clinical data to determine medical necessity for services in accordance with policies, guidelines, and National Committee for Quality Assurance (NCQA) standards. Roles
We are looking for experienced US Registered Nurses (USRNs) to support utilization management activities involving the review of medical necessity, appropriateness, and efficiency of healthcare services through comprehensive evaluation of clinical documentation and medical records while ensuring
Work ScheduleStandard (Mon-Fri) Environmental ConditionsOffice Job Description Join Us as a Lead Medical Project Coordinator At Thermo Fisher Scientific, you’ll discover meaningful work that makes a positive impact on a global scale. Join our colleagues in
Req ID: 379926 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently
Job description: Department: Clinical Operations / Afterhours Intake Employment Type: Full-time Location: Paranaque City, Onsite Reports To: Clinical Supervisor / Nursing Supervisor Position Overview The Afterhours Intake supports the intake and referral processing operations for Supportive
Job description: Department: Clinical Operations / Case Management Employment Type: Full-time Location: Parañaque City – On-site Reports to: Clinical Supervisor / Case Management Supervisor Job Overview The Case Managemer provides administrative and operational support to the
We are hiring for US QA Training Specialist (El Paso Account), Non-Voice Support in BGC, Taguig city. This is hybrid work setup/Temporary work from home following a flexible shifting schedule if the business asks to. (weekends,
We are hiring for US RN Training Specialist (El Paso Account), Non-Voice Support in BGC, Taguig city. This is hybrid work setup/Temporary work from home following a flexible shifting schedule if the business asks to. (weekends, night