Plan Reviewer Salary at City Of Warren Ltd BETA

Trauma Quality Improvement Program: Looking for someone with Trauma and Quality experience. About Troy Hospital Recognized by the US News & World Report as one of the best in the nation for orthopedics and urological services. It has also been ranked #3 on the Worlds Best Hospitals list by Newsweek. This state-of-the-art center provides advanced specialty and routine care with an emphasis on patient satisfaction and a focus on medical advancement. Scope of work The PI Clinical Reviewer collects, analyzes, and reports clinical data elements for the Michigan Trauma Quality Improvement Program MTQIP/TQIP eligible cases as required for participation in the MTQIP/TQIP, a BCBS/Blue Care Network of Michigan funded Collaborative Quality Initiative (CQI). The chief responsibility of the Clinical Reviewer is to work collaboratively with the trauma program registry staff, clinical staff, and the trauma program manager to collect and submit reliable data to MTQIP/TQIP in a timely manner. This is a

JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against evidence based clinical guidelines. Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conducts inpatient reviews to determine financial responsibility for Molina Healthcare an

JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against evidence based clinical guidelines. Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conducts inpatient reviews to determine financial responsibility for Molina Healthcare an

JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against evidence based clinical guidelines. Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conducts inpatient reviews to determine financial responsibility for Molina Healthcare an

JOB DESCRIPTION For this position we are seeking a (RN) Registered Nurse who has a OH Licensure and/or have Compact RN license. The Care Review Clinician will provide prior authorization for inpatient services for the OH Medicaid population. Strong post-acute level of care experience (Nursing Facilities, Acute Inpatient, Rehabilitation, Long Term Acute care hospital. Excellent computer multi-tasking skills and good productivity is essential for this fast-paced role. Good analytical thought process is important to be successful in this role. Prefer candidates that have experience in Nursing Facilities, Acute Inpatient, Rehabilitation, Long Term Acute care hospital. WORK SCHEDULE: Monday thru Saturday 6:00AM to 7:00PM EST (Must be able to work on Saturdays, options for 5- or 4-day work schedules, where one day must be Saturday) This is a Remote position, home office with internet connectivity of high speed required. Job Summary Molina Healthcare Services (HCS) works with members, provide

JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against evidence based clinical guidelines. Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conducts inpatient reviews to determine financial responsibility for Molina Healthcare an

JOB DESCRIPTION Job Summary Molina Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential. HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service. KNOWLEDGE/SKILLS/ABILITIES Assesses inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. Analyzes clinical service requests from members or providers against evidence based clinical guidelines. Identifies appropriate benefits, eligibility and expected length of stay for requested treatments and/or procedures. Conducts inpatient reviews to determine financial responsibility for Molina Healthcare an

Job Description Job Description 1 year contract- looking for Associate degree or two years of college in mechanical design. Excellent entry level opportunity. Need basic SolidWorks or CATIA knowledge. Knowledge of GD & T. These candidates will be responsible for detailing vehicle components- for automotive and aerospace equipment. Candidates will be a part of design and drawing review and interface with Design Engineers to learn more. They will be responsible for detailing and checking to assist the design department. Exceptional growth capability. Pays $15 an hour and benefits. Must have completed CAD training coursework. Immediate start!! Company Description G-TECH Services, Inc. is a leading certified recruitment and placement firm that provides high-quality, flexible staffing solutions to a nationwide client base. We pride ourselves in keeping employee attrition low and offering exciting career opportunities to Engineers and IT professionals! We are large enough to make a differenc