Ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. May require a bachelor's degree. Typically reports to a head of a unit/department. Typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. view job details

Manages the team responsible for evaluating proposed and/or delivered healthcare services to determine if the services meet established health plan coverage guidelines. Receives, reviews, and acts on pre-authorization requests from service providers for medical procedures, treatments, admissions, and medications. Reviews patient and clinical information to ensure compliance with established utilization review guidelines. Refers more complex requests and those that need clinical review to a medical reviewer. Requires a bachelor's degree. Typically reports to a director. Manages subordinate staf... view job details

Responsible for evaluating proposed dental services to ensure proposed treatments are medically necessary, cost-effective, and comply with clinical guidelines and policy coverage. Utilizes clinical criteria and evidence-based guidelines to evaluate the necessity and appropriateness of treatments as well as compliance of utilization review guidelines. Reviews patient records, X-rays, and clinical documentation to approve or deny proposed procedures. May require a bachelor's degree. Typically reports to a manager. Occasionally directed in several aspects of the work. Gaining exposure to some of ... view job details

Supervises the team responsible for evaluating proposed and/or delivered healthcare services to determine if the services meet established health plan coverage guidelines. Receives, reviews, and acts on pre-authorization requests from service providers for medical procedures, treatments, admissions, and medications. Reviews patient and clinical information to ensure compliance with established utilization review guidelines. Refers more complex requests and those that need clinical review to a medical reviewer. May require a bachelor's degree. Typically reports to a manager. Supervises a group ... view job details

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Educate Employees as to How Performance Reviews Affect Their Pay It's Performance Review Season. Is Your Process Working? Insight from Employees on Performance Reviews and Seven Tips for Everyone to Get More from the Process EMPLOYER MYTH #1:  Your employees "Get It." FACT:  Many employees don't understand how the performance review impacts their compensation. Generally speaking, the majority of employees don't have a clear understanding of how their employer links pay to performance. For managers who have been trained in the organization's performance management program and merit budg... view article details

Exceeding your annual performance expectations may seem impossible. But, according to Nick Camelio, Vice President of Human Resources at Salary.com? that doesn’t have to be the case. The key to exceeding your performance expectations is to be an active participant in establishing your goals from the start. By focusing on key objectives and defining a plan that makes sense for you and your employer, you are on your way to meeting and exceeding your performance goals. To help get you started, Camelio offers the following 6 tips:1. Understand your Role The first step ... view article details

The rules of performance reviews are changing. Not too long ago, management guru Peter Block said, 'The performance review is the company's opportunity to prove to you, once again, that they own you.' But as employees gain better access to information and assume more responsibility for managing their careers, the performance review is becoming another opportunity for you to demonstrate value to your company.The Purpose of a Performance ReviewPerformance reviews give employees and employers a chance to evaluate regularly whether they are happy with each other. The review is a meeting between yo... view article details

Performance reviews present an opportunity for employees to demonstrate their accomplishments and distinguish themselves and their value to the organization. It is important to maximize use of this critical tool, as it has significant impact on pay, professional development, and job security. Here are ten tips to make the annual performance review work best for you, while also making it easier on your boss to write you a terrific review: 10. Know Your Role During Performance Review If you are uncertain about any aspect of your job, seek clarification. A great place to start is a detailed list ... view article details

Working in the airline industry can take you places. Even from an elevation of only 110 feet -- the official above sea level height of the city of Everett – which is the site of The Boeing Company’s commercial airplane plant on Washington state's northernmost coast. The career path of Bridget Beckmyer-Johnson provides clear evidence of the 'sky’s the limit' type of opportunities available to the dedicated employee. Her passion for people and learning has transported her from an entry-level position as an airplane “sealer” all the way to management during her 15-year tenure at the plant.Between... view article details

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