Utilization review remote jobs in Hoboken, New Jersey - Page 2Create job alerts

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 yearsWebsite: • Email:

Dane Street, a nationally recognized Independent Review Organization (IRO), is expanding its panel of Physician Reviewers. We are currently seeking Board-Certified Orthopedic Spine Surgeons with an active New York medical license and Workers Compensation Board Certification to conduct Utilization Reviews. This is a fully remote, non-clinical role offering supplemental income with flexible scheduling. Physicians provide objective, evidence-based opinions on the medical necessity of treatment requests and appeals. No patient contact, no treatment, and no doctor-patient relationship is established. Key Responsibilities: * Review medical records to determine the medical necessity of services * Utilize state-specific workers compensation guidelines and nationally recognized criteria * Submit clear, concise, and well-supported determinations * Complete reviews within required timeframes (typically 1 5 business days) * Participate in peer-to-peer calls as needed (coordinated by Dane Street) * Complete addenda when new information is provided Role Highlights: * Independent contractor (1099) status * Average case takes 15 minutes or less * Flat rate per case consistent, supplemental income * Fully remote work from anywhere * You control volume and availability * No direct patient interaction or treatment * Chronological, pre-organized medical records provided * User-friendly portal and streamlined case management * Full onboarding and ongoing support included Requirements: * Board Certification in Orthopedic Surgery (Spine focus preferred) * Active, unrestricted New York medical license * Workers Compensation Board Certification (New York) * Active clinical practice About Dane Street: Dane Street is a national leader in Utilization Review and Independent Medical Review services. We partner with highly qualified, actively practicing physicians to ensure high-quality, evidence-based clinical decisions that support better outcomes across the healthcare system. Apply today to join our Physician Review Panel and start earning on your schedule.

Job Description Suicide Prevention/Team Leader Work Location: 1310 Rockaway Parkway, Brooklyn Hours: Full Time 35 hours per week, Availability requires late afternoons, evenings and Saturdays. This position is 100% fully in-person. No remote work available Salary: $60,000 - 65,000 BCS partners with people to overcome obstacles on their pathway toward self-determination. Since 1866, founded on the principle of neighbors helping neighbors, BCS has worked in neighborhoods impacted by systemic poverty. Today, we continue to strengthen communities by fostering the educational success of children, the leadership development of youth, the employment and housing stability of adults, the advancement of individuals living with disabilities, and the empowerment of seniors and families. Our work is rooted in the struggle for social justice and through action and advocacy we commit to shine a light on barriers that perpetuate inequitable systems as a part of the collective effort to ignite change. BCS serves more than 20,000 people in 42+ programs through the work of approximately 400 staff and 900 volunteers. Position Overview: The Suicide Prevention Programs for Hispanic/Latino, black/African American, Asian American/Pacific Islander, American Indian/Alaskan Native and LGBTQI+ New York Youth and Young Adults. The Team Leader ensures an effective therapeutic milieu is established and ingrained in all aspects of the Suicide Prevention Program through the application of best practices in their work with youth and families. The primary role of this position is to establish a healthy relationship with each participant in the group and provide guidance, modeling, and opportunities for the youth as well as, independent living and parenting skills. Responsibilities: * Orient, train, and provide clinical and task supervision to program staff and interns including weekly individual and group supervision * Conduct assessments of clients per OMH and program policies and procedures * Manage interactions with clients to ensure an appropriate level of support is provided in an efficient manner * Provide crisis intervention, suicide prevention, and brief supportive counseling to young adults who are in emotional distress * Oversee responsibility for maintenance of individuals records, including timely documentation as required the Office of Mental Health * Act as member of an interdisciplinary treatment team including facilitation of weekly administrative, clinical, and utilization review meetings * Assist in managing day to day activities in the absence of the Program Director * Coordinate special projects related to treatment services, quality assurance, and intake * Develop training and guidance materials to ensure staff competence and program continuity * Provide direct individual and group clinical services and case management, as needed * Provide crisis management, as appropriate * Carry a twenty-four hour support cell phone in rotation with Program Director * Participate in agency-wide groups and meetings as required * Other tasks as may be required Qualifications Required: * Master of Arts, MSW or Masters in Mental Health Counseling * Two years post-graduate experience in mental health or closely related field * One year supervisory experience * Experience with group work and family work, and a commitment to working with young adults and their families. * Ability to work with culturally diversified individuals. * Ability to conduct training and on-going workshops; ability to plan events. * Must have knowledge and experience in child development, safety, and nutrition; adult learning principles, and family dynamics. * Must be a strong communicator and have the ability to motivate others. * Must have knowledge of community resources and skills to link families with appropriate agencies and services. * Ability to establish professional boundaries and engage in professional behaviors that emulate a high level of ethics and objective/non-judgmental approaches * Must undergo pre-employment screenings such as the Criminal Background Check required by DOHMH BCS is an Equal Opportunity Employer. Auxiliary aids and services are available upon request to individuals with disabilities