utilization review slp - pchp Jobs - 245
Utilization Review Nurse
Oswego Health - Oswego,NY
Employment Type : Full-Time
Job Title: Utilization Review Nurse Department: Case Management Reports to: VP of Quality & Patient Safety Revision Date: 06/24/2025 Status: Non-Exempt Job...
Budget Analyst- Administration Shared Services
Stony Brook University - Stony Brook,NY
Employment Type : Full-Time
Job Description - Budget Analyst- Administration Shared Services (2501400) Budget Analyst- Administration Shared Services Required Qualifications (as evidenced by an attached resume): Bachelor's degree (foreign equivalent...
Grievance and Appeals Clinical Specialist
VNS Health - New York,NY
Employment Type : Full-Time
Overview Resolves grievances, appeals and external reviews for one of the following VNS Health Plans product lines - Managed Long-Term Care (MLTC), Medicare Advantage (MA), or Select Health. Ensures regulatory compliance,...
Dental Claims Review Analyst - Remote
EmblemHealth - New York,NY
Employment Type : Full-Time
Summary of Job Analyze, review, and process suspended claims, predetermination, and Service Requests based on industry standards and clinical guidelines. Research, analyze, and investigate member benefits, policy and...
Lead Analyst, Configuration Oversight - Payment Integrity - Remote
Molina Healthcare - Yonkers,NY
Employment Type : Full-Time
Job Description Job Summary We are seeking a highly experienced Lead Analyst, Configuration Oversight to support our Payment Integrity and Claims Operations teams in ensuring the accuracy and...