Trabajos medical reviewer en Union City, New JerseyCrear alertas

Provider Resources, LLC ( PRI ) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans.As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care prov

Provider Resources, LLC ( PRI ) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans.As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care prov

Provider Resources, LLC ( PRI ) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans. As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans. This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice. What Should I Expect? Performs comprehensive medical record peer reviews for determination of appropriate clinical outcomes in accordance with all State and Federal mandated regulations Make clinical judgments based on clinical experience and evidence-based medical research as a Subject Matter Expert (SME) in your clinical area of expertise Maintain compliance with all regulation changes as they impact medical and utilization review practices Document all review information as instructed Communicate report results to the appropriate supervisor Access electronic health information, as assigned/granted Do I Qualify? Must hold a current medical license Must be board certified within their clinical specialty (as appropriate) Currently works a minimum of 20 hours per month within their area of clinical specialty Must have a minimum of 5 years full-time experience in direct care Must be actively seeing patients within the last 3 years Website: • Email:

Provider Resources, LLC (PRI) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans. As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans. This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice. What Should I Expect? Performs comprehensive medical record peer reviews for determination of appropriate clinical outcomes in accordance with all State and Federal mandated regulations Make clinical judgments based on clinical experience and evidence-based medical research as a Subject Matter Expert (SME) in your clinical area of expertise Maintain compliance with all regulation changes as they impact medical and utilization review practices Document all review information as instructed Communicate report results to the appropriate supervisor Access electronic health information, as assigned/granted Do I Qualify? Must hold a current medical license Must be board certified within their clinical specialty (as appropriate) Currently works a minimum of 20 hours per month within their area of clinical specialty Must have a minimum of 5 years full-time experience in direct care Must be actively seeing patients within the last 3 years Not currently employed by the VA Website: • Email:

Provider Resources, LLC (PRI) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans. As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans. This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice. What Should I Expect? Performs comprehensive medical record peer reviews for determination of appropriate clinical outcomes in accordance with all State and Federal mandated regulations Make clinical judgments based on clinical experience and evidence-based medical research as a Subject Matter Expert (SME) in your clinical area of expertise Maintain compliance with all regulation changes as they impact medical and utilization review practices Document all review information as instructed Communicate report results to the appropriate supervisor Access electronic health information, as assigned/granted Do I Qualify? Must hold a current medical license Must be board certified within their clinical specialty (as appropriate) Currently works a minimum of 20 hours per month within their area of clinical specialty Must have a minimum of 5 years full-time experience in direct care Must be actively seeing patients within the last 3 years Website: • Email:

Provider Resources, LLC ( PRI ) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans. As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans. This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice. What Should I Expect? Performs comprehensive medical record peer reviews for determination of appropriate clinical outcomes in accordance with all State and Federal mandated regulations Make clinical judgments based on clinical experience and evidence-based medical research as a Subject Matter Expert (SME) in your clinical area of expertise Maintain compliance with all regulation changes as they impact medical and utilization review practices Document all review information as instructed Communicate report results to the appropriate supervisor Access electronic health information, as assigned/granted Do I Qualify? Must hold a current medical license Must be board certified within their clinical specialty (as appropriate) Currently works a minimum of 20 hours per month within their area of clinical specialty Must have a minimum of 5 years full-time experience in direct care Must be actively seeing patients within the last 3 years Website: • Email:

Provider Resources, LLC ( PRI ) is seeking board-certified clinicians to join our panel for an important mission of ensuring quality healthcare for our Nation s Veterans. As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans. This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice. What Should I Expect? Performs comprehensive medical record peer reviews for determination of appropriate clinical outcomes in accordance with all State and Federal mandated regulations Make clinical judgments based on clinical experience and evidence-based medical research as a Subject Matter Expert (SME) in your clinical area of expertise Maintain compliance with all regulation changes as they impact medical and utilization review practices Document all review information as instructed Communicate report results to the appropriate supervisor Access electronic health information, as assigned/granted Do I Qualify? Must hold a current medical license Must be board certified within their clinical specialty (as appropriate) Currently works a minimum of 20 hours per month within their area of clinical specialty Must have a minimum of 5 years full-time experience in direct care Must be actively seeing patients within the last 3 years Website: • Email:

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

We are actively recruiting specialists in the following areas:.Physical Medicine & Rehabilitation - Spinal Cord Injury Medicine.Physical Medicine & Rehabilitation - Neuromuscular Medicine.Physical Medicine & Rehabilitation - Brain Injury Medicine.As a VA medical reviewer, you will conduct thorough,

Job Description At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we're more than a service provider—we're your trusted partner in innovation. Are you a board-certified physician looking for a flexible, remote opportunity to apply your clinical expertise? We are seeking experienced Primary Care Physicians to conduct independent case reviews for the Department of Veterans Affairs (VA). This role involves evaluating medical cases to assess quality of care, adherence to standards, and opportunities for improvement. This is an ideal opportunity for physicians seeking part-time, flexible work that complements their clinical practice. Position Details: • Job Type: Part-time, • Location: Fully remote (U.S. only), • Schedule: Flexible—complete cases at your convenience within 5 calendar days, • Case Volume: Varies monthly—no fixed predictions by specialty or case typeKey Responsibilities:1. Medical Case Audits & Quality Reviews, • Conduct objective medical case reviews using standardized assessment criteria, • Evaluate the timeliness and appropriateness of care provided, • Identify quality improvement opportunities2. Performance Improvement & Specialty Case Reviews, • Review cases initiated for non-standardized performance improvement reasons, • Assess medical decision-making and compliance with best practices3. Medical Advisory Opinions, • Provide expert medical opinions, • Active, unrestricted physician license in any U.S. state or territory, • Board certification in one of the specialties below recognized by the American Board of Medical Specialties, • Family Medicine, • Preventive Medicine, • Internal Medicine, • Minimum of 5 years of clinical experience in your specialty, • Minimum of 2 years of recent clinical practice in your specialty., • Actively engaged in direct patient care (minimum 20 clinical hours per month), • Hospital privileges in your specialty What to Expect Next: After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting. Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law. Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).

Job DescriptionAbout Project EATS Project EATS occupies a unique space in the urban agricultural landscape of New York City. Founded in 2009 by artist and social activist Linda Goode Bryant, Project EATS is a living installation transforming vacant lots and rooftops into neighborhood-based farms catalyzing creativity and cultivating greater food sovereignty. Project EATS food systems grow, harvest, market, and work to increase the consumption of food that nourishes people in the neighborhoods and communities where they live. Over the past 16+ years, we have operated more than 20 farms across New York, now running soil, hydroponic, and green roof farms across 4 sites throughout the city. We partner with the community through multiple workforce development, community-building activities, and arts engagement work. About the Role - Operations and Administration Lead The Operations and Administration Lead is the conductor of our internal ecosystem. Succeeding a long-tenured and successful predecessor, you will ensure the seamless harmony of our business functions for our 9 full-time staff, alongside a seasonal surge of part-time team members during the growing season. Your mission is to maintain the high standard of operational excellence we’ve built over the last eight years while refining processes to support our continued growth. This role is a blend of high-level strategy—serving as a thought partner to the leadership team—and hands-on execution across operations, finance, HR, and IT. We seek a professional who can manage the systems that serve as our foundation, ensuring Project EATS has the operational capacity to cultivate greater food sovereignty across NYC. Key Responsibilities • Financial Oversight & Contracts: Partner with our external bookkeeper to manage day-to-day fiscal activities, including the timely processing of invoices and payment of bills. You will oversee billing, AR/AP, and expenses, while serving as the primary reviewer for organizational contracts., • Development & Gala Support: Partner with the Development team to provide the operational backbone for fundraising initiatives. This includes managing vendor contracts, logistics, and volunteer coordination to ensure the successful execution of our annual Gala., • HR & Talent Liaison: Serve as the primary point of contact for our outsourced HR leadership and benefits brokers. You will ensure HR compliance, manage benefits administration, and keep our internal policies competitive, up-to-date, and clearly communicated., • Culture & People: Proactively evaluate staff engagement and recruitment processes to nurture a healthy, inclusive, and balanced office culture. You will serve as the internal bridge for HR concerns, ensuring they are addressed professionally., • Systems & IT Management: Monitor IT vendor relationships and identify opportunities for infrastructure improvements to keep our multi-site farm operations connected and efficient., • Effective Collaborator: You have successfully worked across cultural lines on a diverse team. You easily gain trust and are known for supporting your colleagues to ensure they are set up for success., • Solutions-Oriented "Do-er": You don’t wait for a manual. You proactively look for ways to offer support, anticipate needs before they arise, and find the best solution to any challenge., • High Integrity & Discretion: You are a guardian of sensitive information. You are known for your sound judgment and for choosing the right decision over the easy one., • Emotionally Intelligent: You are a self-aware communicator who builds trust easily. You are empathetic, curious, and able to navigate stressful situations—like gala season or harvest surges—with professional grace., • Abundant Thinker: You believe that the right team of partners can make incredible things happen. You bring relentless curiosity and creativity to every task and project., • Proven Experience: 4–6 years of professional experience in operations, HR, or finance. We are "background agnostic" and value candidates with non-traditional paths who have proven they can run a tight ship., • Analytical Fluency: You must be comfortable and fluent with Excel and numbers. A genuine interest in data and financial accuracy is vital for success in this role., • Project Leadership: A track record of handling multiple deadlines and completing complex assignments with minimal supervision., • Impeccable Organization: You are highly detail-oriented and get genuine satisfaction from creating orderly, polished processes., • Operational Versatility: The ability and willingness to pivot from partnering with leadership on gala logistics to tactical tasks like managing insurance renewals or booking team travel., • Employer-covered medical insurance, commuter benefits, FSA, (optional) employee-paid dental + vision, • 10 paid holidays per calendar year, plus the week between 12/25-1/1 and the employee’s birthday, • 15 Vacation days + 5 Sick days, • 50% off Project EATS produce and Prepared EATSThe starting compensation for this position is a non-negotiable annual salary of $75,000. We are not able to negotiate salary with anyone in order for us to ensure equity across all candidates. This position is full-time, and you must already be based in the New York metro area. This role is expected to be in the office (Lower East Side, Manhattan) three days a week. You are free to work from home during our regular office hours the rest of the week, but you may be required to come into the office on additional days, or work evenings as events arise. The Application Process Project EATS has engaged Equitable Hiring Group to support this hiring process. To apply, please complete the short form to the right. Please submit your application by Thursday, March 12th. Our simple process makes it easy to apply early! To ensure an equitable review, we ask that you remove the names of the schools you attended (both undergraduate and graduate) from your resume. Please retain the degree itself. For example, instead of "Greendale Community College - B.A. Economics," simply list "B.A. Economics." This evaluation process will follow practices shown to reduce bias in decision-making and may be different from other application processes you have experienced. The overall evaluation process will look to follow this anticipated timeline: • Mid-March: Selected candidates will be asked to complete a short-answer questionnaire., • Mid-March: Selected candidates will participate in a video interview with PE staff., • Late March: Selected candidates will be asked to complete a paid, timed trial project., • Early April: Selected candidates will participate in an in-person panel interview with multiple team members., • Mid-April: Offer extended. Powered by JazzHR lFg3RwXO9h

Job DescriptionPosition Summary: As a Licensed Master Social Worker at MedReview you will be responsible for conducting policy and procedure manual review, pre-opening licensure, re-licensure surveys and associated tasks for Licensed Home Care Services Agencies (LHCSAs). This is a Monday – Friday in-person role which requires travel throughout all 5 boroughs. Salary: $72,500 annually. Responsibilities: • Review and approve policy and procedure manuals to ensure compliance with Article 36 Title 10 of New York State Rules and Regulations (10NYCRR), • Conduct pre-opening tasks which include, but are not limited to Article 36documents review, conference calls, and on-site surveys, • Write letters to the agencies regarding the policy and procedure manual if not in compliance with Article 36 Title 10 of New York State Rules and Regulations, explaining necessary revisions, • Write letters to LHCSAs and DOH recommending either licensure or failure after pre-opening survey., • Follow up with applicants regarding outstanding manual corrections, including writing letters to them, as necessary., • Make recommendations to DOH that applications be withdrawn when applicant fails to submit required material., • Review the agencies’ environmental space, equipment, personnel files, and personnel knowledge on the policy and procedure manual during the on-site preopening visit., • Conduct operational on-site surveys of LHCSAs, which consist of reviewing a sample of client records, personnel records, QI/QA meeting minutes, Governing Authority meeting minutes, the policy and procedure manual, the agency’s Federal Tax ID number, operating license, complaint log, admission packet and on-call procedure., • Write Statements of Deficiencies (SODs) if applicable, of the surveyed agencies using the DOH’s ASPEN computer program., • Assist with the preparation and scheduling of the pre-opening site visits., • Review site Assessment Report and discusses questions/concerns with Director., • Prepare for the required travel, materials and transportation options., • Maintain flexibility regarding workspace and environment while in the field., • Meet co-reviewer(s), if applicable, at the appointed location and time., • Continually works to create an environment of teamwork toward common goals, mutual support and respect., • Tracks all aspects of the work process, as required by the Director, LHCSA., • Master’s degree in Social Work and licensed in New York State (LMSW/LCSW), • Two years of experience in social work preferred, • Experience in home care, • Demonstrates logical reasoning & critical thinking skills, • Detail oriented, highly organized work skills, • Demonstrates a mature, professional, respectful, demeanor and style, • Excellent verbal and written communication skills, • Computer skills including proficiency in Microsoft Word and Microsoft Excel, • Quality improvement orientation, • Flexibility to travel at times for several hours, • Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents., • 401(k) with Employer Match - Join the team and we will invest in your future, • Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays., • Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered., • Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional. gOsznkL3Ai

As a VA medical reviewer, you will conduct thorough, objective case reviews to assess the quality and appropriateness of care provided to Veterans.This is a remote, flexible position that allows you to contribute your clinical expertise while maintaining your current practice.Performs comprehensive

Job Description Position: UAS RN Assessor Location: Hybrid (Must reside within the New York Tri-State Area - NY, NJ, or CT) Must be willing to cover Bronx, NY area Schedule: Monday - Friday 9am-5pm Compensation: $105,000 - $113,000 Join VillageCare as a Full-Time Nurse Assessor and embrace the opportunity to contribute to the health and wellness of your community. Enjoy the flexibility of a hybrid work environment while engaging with diverse patients who rely on your expertise. In this role, you'll solve complex challenges and provide customer-centric solutions, all within a supportive and energetic environment. With a competitive salary ranging from $105,000 to $113,000, you will be rewarded for your commitment to excellence and integrity in healthcare. You will receive great benefits including a generous PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b) with a 5% yearly employer contribution, Life and Disability, Commuter Benefits, mileage reimbursement, Paid Family Leave, and access to additional employee discounts. Don't miss this chance to be part of a forward-thinking organization that values your skills while offering a work-life balance. Apply today and make a difference! Introduction: VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a number of Medicaid and Medicare managed care plans, and through our Assisted Living Program. VillageCare has delivered quality health care and social services to individuals residing within New York City for over 45 years. Our service area now includes all five boroughs of NYC, as well as Westchester, Nassau, and Putnam counties. Your day as a Nurse Assessor: As a Nurse Assessor at VillageCare, you will play a vital role in ensuring the health and well-being of our Members through comprehensive assessments using the NYS Department of Health Universal Assessment System (UAS). Your responsibilities include: • Conducting both in-person and telephonic assessments, where you'll evaluate clinical, social, and individual needs to create tailored care plans., • Collaborating with our assessment scheduling team, you'll confirm assessment sessions and engage with Members, families, and providers to gather crucial information. Your clinical expertise will guide you in reviewing care plans, providing essential self-care training, and ensuring Members have access to valuable resources., • You'll document assessments promptly and work closely with the Quality Manager and UAS Nurse Reviewer to enhance the accuracy of assessments. To thrive as a Nurse Assessor at VillageCare, you must possess a blend of education, experience, and technical skills. • A minimum of an Associate's degree in nursing is required, while a Bachelor of Science in Nursing (BSN) is preferred., • Holding an active NYS RN License and valid NYS identification is essential., • Candidates should bring at least two years of clinical experience, ideally in home health care or within a health plan., • Familiarity with NYS Managed Long Term Care (MLTC) and Medicaid/Medicare plans will enhance your candidacy., • Proficiency in the NYS Department of Health's Uniform Assessment System (NYS-UAS) is preferred, although we will facilitate training., • Strong analytical and problem-solving skills are a must, along with proficiency in standard office software applications like MS Word, Excel, Outlook, and PowerPoint., • Familiarity with electronic health records systems and the ability to communicate in the languages spoken by VCMAX Members, such as Spanish or Mandarin, will further contribute to your success in this role. Are you ready for an exciting opportunity? So, what do you think? If you can meet these requirements and perform this job as described above, we would be happy to have you as part of our team! VillageCare is an Equal Opportunity Employer. Job Posted by ApplicantPro

Job DescriptionAre you looking to join a company where your contributions truly matter, and where you'll be part of a supportive, innovative team? MMS is a award-winning, data-focused clinical research organization (CRO). We pride ourselves on being a Great Place to Work certified organization, recognized for our exceptional culture and industry best employee retention rate. We support the pharmaceutical, biotech, and medical device industries with our proven, scientific approach to complex trial data and regulatory submission challenges. With a global footprint across four continents, MMS not only maintains an industry-leading customer satisfaction rating but also fosters a collaborative and inclusive work environment where employees can thrive. Join us at MMS and be part of a team that is shaping the future of clinical research. Discover more about our exciting opportunities and why MMS is a great place to advance your career. Visit or follow MMS on LinkedIn. This role is a project-based consulting opportunity to conduct medical monitoring on an as-needed basis. This is not a full-time position. Role & Responsibilities • Provide medical input into the development and execution of study documents and plans, such as study protocol, IB, SMP, DMP, SAP, Lab manuals, etc., • Provide medical expertise to sponsors in the drug development process, • Provide significant expertise as primary medical reviewer of individual adverse event reports, clinical, and safety documents, • Lead safety activities on assigned product(s) that may include interactions with other functional groups in the company, • Responsible for medical monitoring tasks, which may include:, • Eligibility review, • Review of safety-related protocol‑related deviations, • Review of safety data, • Develop Medical Monitor Plan, • Participation in medical monitoring and/or safety review meetings as needed, • Medical management of queries, • Medical coding review, • Maintain records and logs, • Medical review of study documents, • Responsible for strategies in pre and post marketing risk management, as well as keeping abreast of pharmacovigilance methods and trends in published literature and global regulations, • Responsible for strategies in monitoring and analysis of cumulative safety information, • Maintains significant knowledge of global and local regulations and guidance as they pertain to medical review and safety reportingJob Requirements, • Medical degree required (MD or equivalent), • Specialty in Ophthalmology or comparable experience in Ophthalmology, • 5 or more years of clinical experience and/ or research experience required, • Relevant experience in safety physician, safety committee membership, medical monitoring and/or medical reviewer in pharmaceutical industry, • Excellent scientific writing skills, • Ability to understand clinical data, • Proficiency with MS Office applications, • Good communication skills 45dSCx8tuj

Job Description Dane Street is expanding our physician panel! This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis. The ideal candidates will hold a NY license and be Board Certified in Neurology with experience in completing Independent Medical Exams. The ideal candidate will be New York State Workers' Comp certified. Independent Medical Exams are available to be completed across the state of New York. Requirements As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care. MAJOR DUTIES AND RESPONSIBILITIES: • Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria, • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision, • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes, • Provides copies of any criteria utilized in a review with the report in a timely manner, • Returns cases on or before the due date and time, • Makes telephone calls as mandated by the state and/or client specifics, • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job, • Attends all required orientation and training, • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits, • Board certification required, active practice required PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment. Benefits Robust opportunity for supplemental income • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability, • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions., • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise, • Expanded credentials as an expert in Independent Medical Exams and physician advisor services, • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery. Apply for this job

Job Description Dane Street is expanding our physician panel! This is a telework opportunity for supplemental income for physicians providing a caseload customized to your schedule. Our physician panel is comprised of independent contract reviewers (1099) compensated on a per-case basis. The ideal candidates will hold a NY license and be Board Certified in Orthopedic Surgery, with experience in completing Independent Medical Exams. The ideal candidate will be New York State Workers' Comp certified. Independent Medical Exams are available to be completed across the state of New York. Requirements As Physician Reviewer/Advisor, you will utilize clinical expertise and reviews insurance appeals, and prospective and retrospective claims. The Physician Reviewer will provide an interpretation of the medical necessity of services provided by other healthcare professionals in compliance with client specific policies, nationally recognized evidence-based guidelines, and standards of care. MAJOR DUTIES AND RESPONSIBILITIES: • Reviews all medical records and addresses each question posed by the client utilizing client specific criteria or other nationally recognized evidence-based criteria, • Ensures that the rationale for the determination is clear, concise, and contains adequate supporting documentation to substantiate the decision, • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer-reviewed literature that support sound and objective decision-making and rationales in reviews; refrains from using case studies, cohorts, and the like to make decisions due to their limited sample sizes, • Provides copies of any criteria utilized in a review with the report in a timely manner, • Returns cases on or before the due date and time, • Makes telephone calls as mandated by the state and/or client specifics, • Maintains proper credentialing and state licenses and any special certifications or requirements necessary to perform the job, • Attends all required orientation and training, • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits, • Board certification required, active practice required PLEASE BE AWARE: In the interest of the security of all parties, Dane Street will never conduct interviews via text or request checks from candidates for any reason including the purchase of equipment. Benefits Robust opportunity for supplemental income • Schedule flexibility and predictable work hours - You choose services and case types, dictate volume, and conduct exams and reviews based on your schedule availability, • No doctor/patient relationship is established and no treatment is provided. These are advisory-only opinions., • Enhanced industry expertise strengthening your medical practice with medical necessity and utilization review/management expertise, • Expanded credentials as an expert in Independent Medical Exams and physician advisor services, • Fully prepped cases, streamlined case flow, transcription services at no cost, and user-friendly work portal Dane Street supports all referral processes, scheduling, preps cases extensively, prepares all medical records, provides transcription services as applicable, facilitates all client communications, and ensures the quality and timeliness of all reports and report delivery. Apply for this job

Job Description Duties: Maintain knowledge of medical record review and EMR systems. Maintain up-to-date knowledge of HEDIS, QARR and Star specifications Distribute requests for records and schedules appointments with provider offices ensure timely completion of duties meet internal and regulatory standards and requirements. Perform clinical audits via EMR, in-house paper medical records, on-site provider visits measure compliance with preventive health guidelines and measure effectiveness of quality improvement initiatives. Identify, track and report variation from standards of care by audit of core operations, patient care processes and medical record documentation. Designs interventions drive improvement and minimize variation from standards of care. Data enter accurate and timely clinical quality findings in the appropriate system(s) in accordance with established documentation standards for Metro Plus Health Plan ensure integrity of member services provided over the continuum of care and over time. Assist in implementation of quality improvement activities as directed by Quality Management programming needs. Support interdepartmental and internal teams focused on process improvement projects and outcomes. Provide educational support physicians and staff ensure process improvement and increase member satisfaction, member retention, continuity of care and drive HEDIS and QARR improvement activities. Facilitate retrieval of medical record documentation and work with provider group(s) and in-field navigators retrieve electronic and paper records that supports HEDIS/QARR. Records findings of patient encounters include patient identifiers, relevant information and results in database. Participate in the annual HEDIS and QARR hybrid medical record review project: Work with provider offices facilitate request and review of charts Supports temporary staff in the review of medical records (electronic and paper-based) Serve as a final reviewer of HEDIS and QARR records Skills: Clinical background: Health Educator, RN, LPN, RN, LMSW or LCSW, Foreign Medical Graduate (FMG) with a minimum of three years relevant work experience. Experience with medical record review working on HEDIS/QARR in a managed care or health plan setting. 3 5 years in Quality Improvement in a health care and/or Managed Care setting strongly preferred. Ability travel within the Metro Plus service area. Knowledge of HEDIS and QARR specifications. Experience using EMR systems, e.g. EPIC, Quadramed. Proficient in Microsoft Office applications including Word, Excel, PowerPoint and Access. Knowledge of ICD-10 and CPT codes preferred. Ability proficiently read and interpret medical records; Ability measure compliance and identify deficiencies in chart documentation against standards. Education: High School/GED with a minimum of years HEDIS review experience. Clinical background preferred (Medical Assistant, Nursing Assistant, Health Educator, LPN, RN, LMSW or LCSW. Experience with medical record review working on HEDIS/QARR in a managed care, health plan or provider office setting. Proficient in Microsoft Office applications including Word, Excel, PowerPoint and Access. Schedule Notes: Shift Time: 9:00AM -5:00PM In person/Hybrid: Field Job Requirements: Maintain knowledge of medical record review and EMR systems. Maintain up-to-date knowledge of HEDIS, QARR and Star specifications Distribute requests for records and schedules appointments with provider offices ensure timely completion of duties meet internal and regulatory standards and requirements. Perform clinical audits via EMR, in-house paper medical records, on-site provider visits collect documentation of measure compliance. Data enter accurate and timely findings in the appropriate system(s) in accordance with established documentation standards for Metro Plus Health Plan ensure integrity of member services provided over the continuum of care and over time.

Job Description Overview Are you an accomplished Board Certified Spine Surgeon or Board Certified Neurosurgeon? Are you passionate about your work/life balance? We are seeking flexible and experienced physicians for our medical reviewstream division. This telecommute role provides the ability for you to customize your schedule and caseload within a Monday - Friday work week and within business hours. Create a flexible work schedule and be compensated on a per case basis as a 1099 independent contractor. Candidates must have a NJ license. JOB SUMMARY: Relying on clinical background, reviews health claims providing medical interpretation and decisions about the appropriateness of services provided by other healthcare professionals in compliance with Concentra Physician Review policies, procedures, and performance standards and URAAC guidelines and state regulations. Responsibilities MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and return to work, short and long-term disability, Family and Medical Leave Act (FMLA), Group health and workers’ compensation claims., • Meets (when required) with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues., • Maintain proper credentialing and state licenses and any special certifications or requirements necessary to perform the job., • Returns cases in a timely manner with clear concise and complete rationales and documented criteria., • Telephonically contacts providers and interacts with other health professionals in a professional manner. Discusses the appropriate disclaimers and appeal process with the providers., • Attends orientation and training, • Performs other duties as assigned including identifying and responding to quality assurance issues, complaints, regulatory issues, depositions, court appearances, or audits., • Identifies, critiques, and utilizes current criteria and resources such as national, state, and professional association guidelines and peer reviewed literature that support sound and objective decision making and rationales in reviews., • Provides copies of any criteria utilized in a review to a requesting provider in a timely manner Qualifications EDUCATION/CREDENTIALS: -Board certified MD, DO, with an excellent understanding of network services and managed care, appropriate utilization of services and credentialing, quality assurance and the development of policies that support these services. -Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post-graduate experience in direct patient care JOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills -Demonstrated ability to perform review services. -Ability to work with various professionals including members of regulatory agencies, carriers, employers, nurses and health care professionals. -Medical direction shall also be provided consistent with the requirement that the physician advisor shall not have a financial conflict of interest -Must present evidence of current error and omissions liability coverage for job duties and activities performed -Managed care orientation -Knowledge of current practice standards in specialty -Good negotiation and communication skills WORKING CONDITIONS/PHYSICAL DEMANDS: -Phone accessability -Access to a computer to complete reviews -Ability to complete cases accompanied by a typed report in specified time frames -Telephonic conferences This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management. Concentra is an Equal Opportunity Employer M/F/Disability/Veteran Concentra's Data Protection Commitment • Concentra is committed to protect patient data and to ensure privacy of personal and medical information., • Every Concentra colleague has the responsibility to adhere to data protection principles., • If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.

Medical Reviewers are the gatekeepers of medical information, ensuring that all materials meet high standards of accuracy and integrity. Industry Trends: Medical Reviewers must stay abreast of evolving regulations, digital health innovations, and data privacy laws to uphold best practices in medical

Active New York medical license. Comprehensive medical, dental, and vision coverage.

Continuing Medical Education (CME) - Receive an annual stipend for continuing medical education. Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance. Competitive Medical, Dental and Vision plans.

Army Physician Assistants serve as versatile medical specialists across the full spectrum of Army medicine If you are a professional in the physician assistant field and want to combine your passions with a desire to serve the U.

Collaborate closely with physicians, medical assistants, and care coordinators. Medical, dental, vision, and life insurance. Dedicated medical assistant and scribe.

Four Season Medical PLLC is seeking a Certified Cardiologist Physician Assistant to join our Family Practice teams at various clinics throughout New York City. Take medical histories and record vital signs.